Section 2102(b)(3)(C) of the Social Security Act requires states to ensure that CHIP does not substitute for private coverage under group health plans. CHIP regulations at 42 CFR 457.805(a) requires states to include a description of the procedures used to protect against substitution of coverage.
One option states use as a method to prevent substitution of coverage in CHIP is a waiting period, which is a period of time an individual must be uninsured after voluntarily disenrolling from group health plan coverage before enrolling in CHIP. Consistent with 42 CFR 457.805(b), the maximum length of time that a waiting period can be in effect is 90 days. Section 457.805(b)(3) of the regulations also requires states to adopt certain exemptions to any waiting period. States have the option to adopt additional exemptions. Regulations at 42 CFR 457.340(d)(3) and 457.350(i) require states to implement processes ensuring a smooth and seamless transition to other insurance affordability programs for which children may be eligible during a waiting period.
As of February 1, 2024, only 9 states have a waiting period. Of the 9 states with waiting periods, 7 have a 90-day waiting period, 1 state has a two-month waiting period, and 1 state has a one-month waiting period. The 30 states with separate CHIPs that do not implement a waiting period protect against substitution of coverage by using various procedures to monitor for substitution, including use of survey data, and private insurance database checks.
The following table provides a summary of state policies in this area as of February 1, 2024.
State | Waiting Period as of February 2024 | Exemptions to the Waiting Period (In Addition to Federally Mandated Exemptions under 42 CFR §457.805(b)(3)) |
---|---|---|
Alabama | None | K.A. |
Arizona | 90 days |
|
Arkansas | 90 days |
|
California | None | K.A. |
Colorado | None | K.A. |
Connecticut | None | K.A. |
Delaware | None | K.A. |
Florida | 2 months |
|
Georgien | None | K.A. |
Idaho | None | K.A. |
Illinois | None | K.A. |
Indiana | 90 days |
|
Iowa | 1 month |
|
Kansas | None | K.A. |
Kentucky | None | K.A. |
Louisiana | 90 days |
|
Maine | None | K.A. |
Maryland | None | K.A. |
Massachusetts | None | K.A. |
Michigan | None | K.A. |
Minnesota | None | K.A. |
Mississippi | None | K.A. |
Missouri | None | K.A. |
Montana | None | K.A. |
Nevada | None | K.A. |
New Jersey | None | K.A. |
New York | None | K.A. |
Oklahoma | None | K.A. |
Oregon | None | K.A. |
Pennsylvania | None | K.A. |
Rhode Island | None | K.A. |
South Dakota | 90 days |
|
Tennessee | None | K.A. |
Texas | 90 days |
|
Utah | 90 days |
|
Virginia | None | K.A. |
Washington | None | K.A. |
West Virginia | None | K.A. |
Wisconsin | None | K.A. |
Totals | 9 states | K.A. |