262073 Louisiana Breaks New Ground: The Nation's First Use of Automatic Enrollment Through Express Lane Eligibility

Tuesday, October 30, 2012

Stan Dorn, JD , Health Policy Center, The Urban Institute, Washington, DC
Ian Hill, MPA, MSW , Health Policy Center, The Urban Institute, Washington, DC
Fiona Adams, BA , Health Policy Center, The Urban Institute, Washington, DC
Created as an option under the CHIP Reauthorization Act, “Express Lane Eligibility” (ELE) lets states qualify children for Medicaid and CHIP based on their eligibility for other programs, such as the Supplemental Nutrition Assistance Program (SNAP). This study examines ELE's impacts on children's enrollment into Medicaid, state administrative costs, and beneficiary experiences in the State of Louisiana, the first state to implement ELE's auto-enrollment feature.

Based on analysis of state administrative data, key informant interviews with state and local officials and focus groups with parents of child enrollees, we found that ELE effectively enrolled thousands of previously uninsured children, simplified the process through which these children were found eligible, and lowered state administrative costs related to outreach, enrollment, and renewal.

Between February and December 2010, Louisiana enrolled more than 20,000 children into Medicaid based on data matches with SNAP. Among new enrollees, more than 50 percent used their Medicaid coverage to obtain care after enrollment. The state also used ELE to automatically renew Medicaid coverage if data matches showed that children were receiving SNAP. This expedited 38 percent of all renewals.

ELE has proven to be less costly than traditional methods. Administrative data revealed that the state saved approximately $1 million on enrollment costs during ELE's first year; renewal saving were even greater--$8 million annually.

Compared to traditional, more burdensome Medicaid eligibility processes, ELE yields significant gains in child coverage while improving administrative efficiency, lessons that may help state and federal policymakers implementing children's coverage under health reform.

Learning Areas:
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe Express Lane Eligibility as a strategy for streamlining children's enrollment into Medicaid and CHIP. Assess the effects of Express Lane Eligibility on children's enrollment into health coverage, access to care, and state administrative costs.

Keywords: Child Health, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-director of this research and was involved in all aspects of the work. I am an expert on issues surrounding Medicaid and CHIP eligibility and enrollment, and strategies for simplifying enrollment and renewal procedures.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.