Children's Health Insurance Expansions: State Experiences in Developing Benefit Packages and Cost-Sharing Arrangements. Stand-alone Insurance Programs: California, Colorado, Florida, Massachusetts, New York, and Pennsylvania


Many states have developed children's health insurance subsidy programs independent of Medicaid in order to have greater flexibility in program design. These states were not required to obtain federal approval, but also were not able to obtain federal matching funds that were available to the states using Medicaid waivers to achieve their coverage objectives. Out of the nine selected states, six have stand-alone programs: Colorado, California, Florida, Massachusetts, Pennsylvania, and New York. Eligibility requirements for these six programs are detailed in Table 2.

Table 2: Eligibility for Children in Standalone Programs (as of August 1997)



Colorado Children's Basic Health Plan

Florida Healthy Kids

Massachusetts Children's Medical Security Plan

New York Child Health Plus

Pennsylvania CHIP

Age 2-18 <13 5-19 <19 1< 19 <16
Income 150-200% FPL <185% FPL No Income Limits No Income Limits <222% FPL <185% FPL
0-6 years: 185-235% FPL
Medicaid Ineligibility Required Yes Yes Yes No Yes Yes