State Children's Health Insurance Program

This memorandum directs the Secretary of Health and Human Services to immediately withdraw two 2007-2008 CMS letters that restricted state flexibility in setting income eligibility for the State Children's Health Insurance Program (SCHIP), which had caused tens of thousands of children to lose coverage.

Federal Register Open PDF 74 FR 6347

Impact dates

Aug 17, 2007
Immediate withdrawal of August 17, 2007 and May 7, 2008 CMS letters and implementation of SCHIP without restrictive requirements

Key directives

Immediately withdraw the August 17, 2007 CMS letter to State health officials
Immediately withdraw the May 7, 2008 CMS letter to State health officials
Implement SCHIP without the requirements imposed by those letters
Publish this memorandum in the Federal Register

Who is ordered

Secretary of Health and Human Services · Department of Health and Human Services

Timeline

Immediate

Withdrawal of August 17, 2007 and May 7, 2008 CMS letters requested
Implementation of SCHIP without the restrictive requirements

Near term (90d)

States may restore or expand income eligibility levels
Potential restoration of coverage for children previously denied

Long term

Expanded SCHIP enrollment depending on state decisions
Potential reversal if future policy changes occur

Risks & tensions

Tension between federal oversight and state flexibility in program administration
No explicit enforcement mechanism if Secretary delays action; 'request' language softened by 'authorized and directed' for publication
Coverage restoration depends on state willingness to raise eligibility levels after federal restrictions lifted
Document disclaims creating enforceable legal rights, limiting judicial recourse