Continuing to work with states to build new systems of health coverage

By Cindy Mann CMS Deputy Administrator and Director, Center for Medicaid and CHIP Services

CMS is committed to working in partnership with states in administering their Medicaid and Children’s Health Insurance Programs (CHIP) and to providing flexibility in pursuit of our shared goals.

Premium assistance has been a longstanding option in both Medicaid and CHIP and is one way to accomplish those shared goals.  CMS provided guidance in December of last year on how states might use these options to develop state-based solutions that meet both the state’s unique needs and requirements of the programs

In response to some questions that have been raised by states, today we are issuing some clarifying guidance.   Today’s Frequently Asked Questions explain the basic requirements that apply when a state chooses the premium assistance option and the guidelines we would apply when a state requests a waiver to implement premium assistance.  Under both approaches, individuals remain Medicaid beneficiaries and continue to be eligible for benefits and cost-sharing protections established by law.

As we review waiver proposals, HHS will consider factors that will impact cost effectiveness, such as those introduced by the creation of Health Insurance Marketplaces.

We remain committed to working with states and providing them with the flexibility and resources they need to build new systems of health coverage.  Premium assistance is simply one option, and we will continue to work with states on solutions that work best to meet shared goals.  We encourage states to come to us with their delivery system ideas, and look forward to continuing to work with states on these and other innovative approaches.

Premium Assistance FAQ

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