Database of State Policies Affecting Marriage
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The Medicaid and SCHIP programs provide health insurance to low-income children and low-income families with children. Eligibility is provided to low-income adults who are not part of a family with children in only some states.
Eligibility for Medicaid is complex, numerous avenues to Medicaid eligibility, including eligibility based on a family’s income in relation to AFDC-related or TANF-related thresholds (“Section 1931” eligibility), income as a percentage of poverty, or income less medical expenses in relation to a different set of income thresholds (“medically needy” eligibility). Some Medicaid eligibility rules provide eligibility to an entire family, while other rules only provide eligibility to selected family members. In particular, eligibility based on a family’s income as a percentage of poverty applies to pregnant women, infants, and children, but not to (non-pregnant) parents. Each state sets the exact rules for Medicaid eligibility. Eligibility rules for SCHIP are also established at the state level. States may use different SCHIP eligibility thresholds for different age groups of children. Due to the many complexities, it is possible for some members of a family to be insured by Medicaid or SCHIP while others are not.
Click the program name to view the long description.