The Department of Job and Family Services is seeking clarification of new federal rules for the State Children’s Health Insurance Program and whether they will curtail a budget act expansion of coverage that also employs Medicaid and other state funds.

The Bush administration informed states that in order to expand SCHIP to cover children in families above 250% of poverty, or $41,300 for a family of four, they must meet certain requirements including a 95% enrollment rate for eligible children up to 200% of poverty.

No state currently meets that stipulation, with Vermont at 91% being the closest, ODJFS reports. Ohio’s enrollment rate is currently 76.6%.

So it’s no surprise that the federal change raised concerns among states that have made recent moves to ex-pand eligibility in SCHIP, which features a more generous state-federal match than Medicaid. However, it remains to be seen how the new rules will affect Ohio’s new program, if at all.

Gov. Strickland proposed and the legislature approved expanded insurance coverage for children in the budget bill (HB 119 ). Under one provision, which would cover children in families at 200-300% of poverty, ODJFS is required to “seek a federal waiver to provide the expanded coverage as the Children’s Health Insurance Program Part III” and charge premiums as a condition for participation, according to the Legislative Service Commission’s final comparison document on the bill.

A separate “buy-in” expansion beyond 300% is funded with general revenue in the measure if SCHIP and Medicaid spending is not allowed by the federal government and requires families to pay a portion of the costs.

ODJFS spokesman Dennis Evans said the agency is seeking clarification of the letter from federal officials. He said ODJFS is authorized in the budget to use Medicaid money for the expansions instead of SCHIP, but is concerned that the new rules could also apply to Medicaid.

“If it’s both, then it does potentially impact the program,” he said. Additional curbs on Medicaid use would “impact our ability to provide the necessary access to coverage we feel is vital to Ohio’s children.”

“A lot of these standards are very restrictive,” Evans added.

The letter signed by Dennis Smith, director of the federal Center for Medicaid and State Operations, states, “These requirements ensure that the extension of eligibility to children at these higher effective income levels do not interfere with the effective and efficient provision of child health assistance coordinated with other sources of health benefits coverage to the core SCHIP population of uninsured targeted low-income children.”

Along with the enrollment requirement, the Centers for Medicare and Medicaid Services also wants states to provide “assurance that the number of children in the target population insured through private employers has not decreased by more than two percentage points over the prior five-year period” and assurance that SCHIP reporting mandates have been adhered to.

Evans said ODJFS questions the federal office’s assumptions in regards to the private employer insur-ance trends. Just because the number of insured has dropped doesn’t necessarily mean it’s as a result of “crowd out” by expanded entitlement coverage, he said.

“It’s dropped not because of SCHIP, but because less people are employed,” Evans said.

Under the 200-300% expansion, the state estimates that nearly 20,000 more Ohio children will be enrolled out of a pool of some 30,000 that are newly eligible.