Who exactly is covered under CHIP in Montana?

Oct 17, 2017

By MBPC Staff

At the end of September, Congress allowed funding for the Children’s Health Insurance Plan (CHIP) to expire. While Montana has funds to keep the program running for the next few months, the state is expected to run out of federal funds in early 2018. The failure of Congress to act before then will put thousands of Montana children at risk of losing their insurance coverage.

But exactly who is at risk of losing coverage has garnered some questions. In Montana, federal CHIP funds create the program known as Healthy Montana Kids (HMK). HMK has two parts – HMK and HMK Plus. The benefits and network of providers are relatively the same for both plans.

For the time being, coverage under HMK Plus is likely to continue because the state is required by federal law to maintain this coverage. However, without action by Congress, coverage through HMK is almost certainly at risk.

Parents can tell which program their children are enrolled in by taking a look at their kids’ insurance cards. Those with insurance cards for HMK include the logo for Blue Cross Blue Shield and are potentially affected by CHIP funding expiring. Children whose cards say Medicaid or HMK Plus are in the Medicaid program and are not affected. Images of the two different insurance cards can be found on the DPHHS site.

Each program has certain income eligibility requirements, based on the federal poverty level data. Below is a chart that provides a comparison of who is covered in each of the programs.

While the Medicaid portion is not at risk with Congress’ failure to extend CHIP funding, in the past the state has received more federal funds for some of these children. Without an extension to CHIP, the federal government will pay less for the 7,000 children in this group. The state will still provide coverage, but will face increased costs.

Unlike children’s Medicaid and HMK Plus, coverage through HMK is at risk of ending if Congress does not extend funding. If Congress does not act, Montana will run out of federal funds by early 2018. At that point, it could choose to continue to provide coverage using state funds, but it would cost roughly $96 million per year in state funds to maintain that coverage.

Alternatively the state may be forced to cut coverage or end the program. This means tens of thousands of children in Montana are at risk of losing their health care coverage in early 2018 if Congress does not act quickly.

What has CHIP and Healthy Montana Kids meant to your family? Share your story with Montana’s members of Congress and tell them about the impact that HMK has had on your family.