Alignment Between Separate CHIP and Marketplace Issuers

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This map highlights the extent of overlap in 2015 between issuers offering managed care plans in a state’s separate Children’s Health Insurance Program (CHIP) and those offering plans in health insurance marketplaces. This map updates a 2014 map showing data from the first year marketplace coverage was available. Plans offered by the same issuer in CHIP and the marketplaces likely differ in benefits and cost sharing. However, overlap in issuers may provide an opportunity for aligning the plans to promote consistency and continuity of care for children who may be moving from one program to another. The map below shows which states had complete, partial, or no overlap between CHIP and marketplace issuers in 2015.[1] You also can find a full list of 2015 marketplace and separate CHIP issuers by state here. This information also complements a report, issued by the Association for Community Affiliated Plans, which analyzes the extent of overlap between marketplaces and Medicaid managed care issuers by state.Like all State Refor(u)m research, this map is a collaborative effort with you, the user—let us know of any changes as decisions are made about CHIP and marketplace issuers in your state. Your feedback is central to our ongoing, analytical process, so tell us in a comment, or email your suggestion to Corinne Alberts at calberts@nashp.org.

 

 

 

[1] States have the option to expand Medicaid, create separate programs, or use a combination of CHIP and Marketplace Keythese approaches for CHIP. This analysis does not include the 8 states and the District of Columbia that use CHIP funding solely to expand their Medicaid programs for children (AK, CA, DC, HI, MD, NH, NM, OH, and SC). We also excluded separate CHIP programs that offered only premium assistance or had limited eligibility criteria, such as those that only covered pregnant women, unborn children, children with disabilities, or children who were new lawful residents (these criteria apply to MN, NE, OK, and RI). Finally, this analysis only includes states that use a managed care delivery system in CHIP (AL, AR, CT, ID, ME, MS, MT, NC, SD, TN, VT, WV, and WY are excluded as they use only fee-for-service or primary care case management delivery systems in CHIP). NASHP obtained 2015 data on separate CHIP issuers from state CHIP officials and data on marketplace issuers from data.healthcare.gov and state marketplace websites between January and March 2015. This analysis provides a state-by-state look at separate CHIP managed care plan issuers and marketplace issuers, but does not identify whether those issuers operate on a statewide basis or in limited areas of the state.

This work was conducted as part of NASHP’s Children in the Vanguard initiative with support from The Atlantic Philanthropies.