This is a partial PDF from the state of Texas.

Notice that the women do not have to be citizens to receive healthcare. The rules have been written so that the unborn baby of any illegal that drags herself across the border, regardless of where she came from and at what stage her pregnancy is, qualifies the illegal for prenatal and medical care.

Now, with pregnant women already infected with Zika coming across the border, the US taxpayer will be on the hook for lifetime medical care of illegal aliens children born with microcephaly

The link to read this PDF is below.

Date: August 1, 2013
Texas Works Bulletin Number: #13-11

To: Eligibility Services – Regional DirectorsProgram ManagersEligibility Services SupervisorsRegional AttorneysHearings Officers

From: Stephanie Stephens, DirectorPolicy Strategy, Analysis, and DevelopmentState Office 2115

Subject: Children’s Health Insurance Program (CHIP) and CHIP perinatal Integratedinto Texas Integrated Eligibility Redesign System (TIERS)

This bulletin is being sent to supervisors and other regional managers. Supervisors must sharethis information with all Texas Works staff. Please ensure copies are provided to staff that donot have access to e-mail. If you have any questions regarding the policy information in thisbulletin, follow regional procedures. Active bulletins are posted on the Texas Works Handbook(TWH) website at

CHIP and CHIP perinatal Integrated into TIERS


CHIP provides health benefits for children under age 19 whose household income exceeds thelimits for Children’s Medicaid (CMA), but is at or below 200% of the Federal Poverty IncomeLimit (FPIL). CHIP perinatal provides health benefits to unborn children of pregnant womenwho are ineligible for Medicaid or CHIP and have income at or below 200% of the FPIL.Currently, eligibility determination and enrollment for these programs are processed byMAXIMUS, a Health and Human Services Commission (HHSC) contractor. Eligibilitydetermination for these programs will now be processed by HHSC staff using TIERS.MAXIMUS will continue as the Enrollment Broker for both programs. CHIP and CHIP perinataleligibility policy may be accessed through the left menu list of the TWH, under the label “OtherMedical Programs.”

CHIP Overview

A child must be determined ineligible for Medicaid before being determined eligible for CHIP.Children who qualify and enroll in CHIP receive up to 12 months of continuous coverage andare required to renew eligibility every 12 months. Households with income above 185% of theFPIL have an income check during their sixth month of eligibility

CHIP perinatal Overview

A pregnant woman is eligible for CHIP perinatal if she is ineligible for ongoing Medicaid or CHIPbecause of income and/or immigration status.The unborn children of pregnant women certified for CHIP perinatal are granted up to 12months of coverage from the month the eligibility determination is made. The enrollment periodincludes the months of CHIP perinatal coverage before and after the birth. The mother receivesCHIP coverage related to the pregnancy only; she does not receive personal health carecoverage.

Current Process

MAXIMUS processes the Form H1014, Application Information for Children’s Health InsuranceProgram (CHIP), Children’s Medicaid, and CHIP perinatal Coverage, using the MAXeCHIP andMAXe-perinatal eligibility determination systems.
• If MAXIMUS determines that a child is potentially eligible for Medicaid, the child iselectronically referred to HHSC for HHSC staff to determine final Medicaid eligibility.
• If a pregnant woman is potentially eligible for Medicaid for Pregnant Women (TP 40),MAXIMUS notifies her of the potential eligibility and informs her of the need to apply forMedicaid.
• If the applicant is ineligible for Medicaid, MAXIMUS determines eligibility and processes theenrollment for CHIP and CHIP perinatal.
If HHSC receives the Form H1014 or Form H1010, Texas Works Application for Assistance –Your Texas Benefits, and determines a child and/or pregnant woman is ineligible for Medicaidbut meets the CHIP or CHIP perinatal eligibility criteria, TIERS sends an electronic deem toMAXIMUS to establish eligibility and enrollment for the individual.

New Process and Policy

HHSC staff will determine eligibility for CHIP and CHIP perinatal. TIERS has been modified toprocess CHIP and CHIP perinatal program eligibility. In TIERS, CHIP is identified as CI – CHIP(TA 84) and CHIP perinatal is identified as CI – CHIP perinatal (TA 85). MAXIMUS will continueto process managed care enrollment for these programs.The following policy information is not exhaustive. Instead, the information focuses on CHIPand CHIP perinatal policy highlights and the differences compared to CMA. Please refer toTWH, Part D, Children's Health Insurance Program (CHIP), for allowable verification sources forCHIP and CHIP perinatal.

Household Composition

CHIPThe household composition rules follow current CMA policy with the exception that:
• the needs of the unborn child are not included in the CHIP budget, and
other related children will be in a separate CHIP Eligibility Determination Group (EDG), ifeligible.

CHIP perinatal
The budget group is the same as it is for CHIP but must also include the following individuals:
• spouse or the father of any mutual children living in the home, and
• unborn child(ren).When mother and daughter are both pregnant and live in the same household, apply thefollowing rules to determine the budget group.

If the pregnant daughter is under age 18, include the pregnant mother and requiredmembers of the household.

• If the pregnant daughter is 18 or older, consider her to be an adult. Only include requiredmembers of the household.Citizenship/Alien StatusCHIPChildren must meet Medicaid citizenship or alien status requirements.

Citizenship/Alien Status

Children must meet Medicaid citizenship or alien status requirements.

CHIP perinatal

A pregnant woman does not have to meet citizenship or alien status requirements. A pregnantwoman can be undocumented and be eligible for CHIP perinatal because it is the unborn childwho is eligible. Citizenship/alien immigration status is self-declared


Verify the identity of all individuals in the certified group. Once HHSC has verified identity for anindividual, do not re-verify.

CHIP Perinatal

Identity is self-declared.

Child Support

Child support requirements do not apply to CHIP or CHIP perinatal. Applicants may obtain childand medical support assistance by contacting the Office of Attorney General.


CHIPHouseholds with net income at or below 150% of the FPIL are not subject to a resource test.

Households with net income over 150% of the FPIL have a $10,000 resource limit.


CHIPVehicles modified for and used to transport a household member with a disability are totallyexempt, regardless of value. Modifications to vehicles used to provide transportation for amember with a disability include lifts, ramps, or hand controls.For vehicles exempt based on use, other than those modified for and used to transport ahousehold member with a disability, exempt:

• one vehicle regardless of value;

• up to $18,000 of the fair market value of second or subsequent vehicles.

Count the excessas a resource.When there are no vehicles that qualify for an exemption based on use, exempt:

When there are no vehicles that qualify for an exemption based on use, exempt:

• $18,000 of the highest valued vehicle; and
• $7,500 of any remaining vehicles.

Read the rest of the PDF at