My 3 year old daughter has been on PA CHIP for 1 1/2 years and it is excellent insurance. I pay the full price based on my income.

I received a letter yesterday stating that the policy does not meet the guidelines of the Affordable Care Act. Since the coverage is extensive and can not be the problem, can you please explain what requirement is not being met by her CHIP plan?

I’ve also been informed that I need to get a waiver for her 2014 coverage in order to not be penalized on my taxes for 2014. She has been fully covered her entire life, so I am at a loss.


CHIP counts as Minimum Essential Coverage and therefore meets ACA guidelines. If you are being asked to prove that it meets guidelines we suggest contacting HealthCare.Gov or your state Medicaid department for clarification.

UPDATE: Some limited benefits CHIP and Medicaid plans don't count as Minimum Essential Coverage.

See official CMS Minimum Essential Coverage guidelines or see our simplified page on Minimum Essential Coverage.

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I contacted the Hotline number provided in the letter I received (letter available on and was told the following:

“The Government is stating that the Full Cost policies do not meet the Federal MEC guidelines and therefore coverage will be eliminated on April 15th”

I was also told that the exact same insurance plan being charged as No Pay or Low Pay (based on income) does meet the MEC guidelines and will remain active.

When I questioned whether the MEC guidelines contained regulations based on payment of the plans and not the actual insurance policy coverage, I was told that “there must be”. I was told to go to to review the specific guidelines for MEC criteria, but did not see any items related to the payment of the insurance policy.

Do you have any idea where I can find a specific listing of the MEC guidelines in its entirety?

Thank you for your assistance!

Trisha on

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MEC (Minimum Essential Coverage) guidelines state that coverage includes CHIP. Since CHIP is a state run program then it’s the states job to make sure they are offering MEC qualified plans. Given this they are most likely discounting the plan in question and will offer a different option… That being said we are talking about a state that didn’t expand Medicaid, so you may want to start looking at HealthCare.Gov for coverage.

Minimum Essential Coverage guidelines, see above link, don’t include some limited coverage CHIP and Medicaid plans. In short, it seems that this pertains to your plan. Most likely your plan pays less than the minimum average cost sharing value of 60% or doesn’t cover some of the new benefits, rights, and protections.