Affordability of Exchange Coverage for Children Now Covered by CHIP

In Chapter 2, the Commission compares the cost of covering children in exchange plans to CHIP. Average additional costs for exchange coverage are estimated to be more than twice that of CHIP if the children’s parents are already enrolled in exchange coverage and more than six times higher than CHIP if the children’s parents are not enrolled, depending on income. In an exchange plan, a family’s total potential exposure (premiums plus maximum service-level cost sharing) to cover children with exceptionally high health needs could exceed 11.7 percent of family income at 160 percent of the federal poverty level (FPL) and 18.8 percent at 210 percent FPL.