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CHIP State Plan Amendments

As part of a strategy to increase transparency, enhance efficiency, and reduce burden for states in the review and approval process of state plan amendments (SPA), CMS committed to providing a tool kit to assist states in the development of complete submissions, and facilitate quicker adjudication of SPA submissions. This page provides a collection of existing CHIP SPA templates for completing the templates that will be enhanced as more tools are developed.

States apply for changes to their CHIP state plan using the CHIP State Plan Template (DOCX, 206.04 KB).  Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.

CHIP State Program Information

In order to be eligible for payment under this statute, each State must submit a Title XXI plan for approval by the Secretary that details how the State intends to use the funds and fulfill other requirements under the law and regulations at 42 CFR Part 457.

States can design their CHIP program in one of three ways:

1.    Separate CHIP: a program under which a state receives federal funding to provide child health assistance to uninsured, low-income children that meets the requirements of section 2103 of the Social Security Act.

2.    Medicaid expansion CHIP: a program under which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act.

3.    Both Separate CHIP and Medicaid expansion: a program under which a state receives federal funding to implement both a Medicaid expansion and a separate CHIP.

CHIP Program by State (PDF, 350.84 KB) has more information about how each state has implemented its program.

To see CHIP information by state, select a state on the map to find details about enrollment and dental providers. Click here for the CHIP Annual Reports.

Results

Displaying 1 - 10 of 953

California

This amendment implements a CHIP Health Services Initiative (HSI) to improve the health of low-income children by increasing their access to needed vision screenings, vision services, and glasses through a targeted, school-based initiative.

Approval Date: April 17, 2025
Effective Date: January 1, 2025
Topics: Benefits Health Services Initiatives

Iowa

Through this SPA, the state is rescinding previously approved SPAs IA-24-0014 and IA-24-0016. These SPAs are reinstated with a new effective date through SPA IA-25-0021.

Approval Date: March 28, 2025
Effective Date: January 1, 2025

Iowa

Through this SPA, the state reinstates previously rescinded SPAs IA-24-0014 and IA-24-0016 with a new effective date of April 1, 2025. Through this SPA, the state provides 12 months of continuous postpartum coverage to individuals enrolled in its separate CHIP and modifies the income levels for both the separate CHIP and title XXI funded Medicaid expansion program for children from ages 0 to 1.

Approval Date: March 28, 2025
Effective Date: April 1, 2025

Montana

This SPA aligns the strategic objectives and goals in section 9 of the state plan with those reported in the state's CHIP Annual Report.

Approval Date: March 13, 2025
Effective Date: December 31, 2024
Topics: Program Administration

Iowa

Through this SPA, the state documents its compliance with the longstanding requirement to cover children's vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.

Approval Date: March 3, 2025
Effective Date: October 1, 2024

Idaho

This SPA provides Idaho with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its CHIP program.

Approval Date: January 17, 2025
Effective Date: January 1, 2025
Topics: Benefits Eligibility Medicaid and CHIP Program (MACPro)

South Dakota

Through this SPA, the state eliminates the CHIP waiting period, consistent with requirements of 42 CFR § 457.805(b).

Approval Date: December 16, 2024
Effective Date: July 1, 2024

Nevada

Through these SPAs, the state amends its CHIP state plan to demonstrate that the state no longer disenrolls children from coverage due to non-payment of premiums during the continuous eligibility period and removes the state’s premium lock out period.

Approval Date: December 16, 2024
Effective Date: January 1, 2024

Tennessee

This letter reactivates Tennessee's approved Evergreen Disaster Relief State Plan Amendment.

Approval Date: December 13, 2024
Effective Date: September 27, 2024

Indiana

Through this SPA, the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023). Additionally, through this SPA, the state confirms the state will not disenroll children from coverage due to late premium payments during the CE period but will disenroll children from coverage if the premiums remain unpaid at the end of the CE period.

Approval Date: December 9, 2024
Effective Date: January 1, 2024