Brief Suggests States Investigate ‘Express Lane Eligibility’ to Enroll Children in Medicaid, CHIP

To expedite enrollment of eligible but uninsured children in Medicaid or the CHIP program, a brief from the Children's Partnership and the Kaiser Commission on Medicaid and the Uninsured suggests that states implement "Express Lane Eligibility," which establishes connections with other public programs that have similar eligibility requirements. The brief suggests that programs such as Food Stamps; the Special Supplemental Nutrition Program for Women, Infants and Children; and the National School Lunch Program could be used to target outreach to uninsured children, to share already gathered information on uninsured children or to determine Medicaid/CHIP eligibility based on a child's enrollment in one of the programs. Before implementing Express Lane Eligibility, the brief encourages states to examine the confidentiality rules of each program, addresses Medicaid/CHIP immigration restrictions, streamline documentation requirements, understand federal verification and Medicaid Eligibility Quality Control rules and target various funding sources. Furthermore, the brief notes "precedents" where linking eligibility for one program with another program has been "incorporated into law and practice." For example, WIC's Adjunctive Eligibility accepts individuals' documented participation in Medicaid, Food Stamps and Temporary Assistance to Needy Families as evidence of income eligibility for WIC. In addition, a Sept. 10, 1998, HCFA letter gave state health officials the authority to "establish an effective referral system between the state's CHIP eligibility agency, the Medicaid and maternal and child health programs and schools, as well as other federal and state agencies that serve low-income families." The report concludes by recommending that states begin to implement an Express Lane approach by targeting the Food Stamp program, as it has a "sufficiently low income threshold" -- 100% of the poverty level -- that most enrollees are also eligible for Medicaid. However, the brief advises states that they "need not stop there" and should look into other public programs to implement Express Lane Eligibility ("Putting Express Lane Eligibility Into Practice," November 2000) The brief is available at http://www.kff.org/content/2000/2211/. HCFA has also made additional information available to States to help improve Medicaid enrollment processes.