Abstract
Objective
We examine a new simplification policy, Express Lane Eligibility (ELE), introduced
by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), to
understand ELE's effects on enrollment, renewal, and administrative costs.
Methods
Beginning in January 2012 and lasting through June 2013, we conducted 2 rounds of
phone interviews with 38 state administrators and staff in 8 states that implemented
ELE in Medicaid, Children's Health Insurance Program (CHIP), or both; we also conducted
case studies in these same states, resulting in 136 in-person interviews. We collected
administrative data on enrollments and renewals processed through ELE methods from
the 8 states.
Results
ELE was adopted in different ways; the method of adoption influenced how many children
were served and administrative savings. Automatic ELE processes, which enable states
to use eligibility findings from partner agencies to automatically enroll or renew
children, serve the most children and generate, on average, $1 million annually in
administrative savings. Given the size of renewal caseloads and the recurring nature
of renewal, using ELE for renewals holds substantial promise for administrative savings
and keeping children covered.
Conclusions
Automatic ELE processes are a best practice for using ELE. However, because Congress
has not yet made ELE a permanent policy option, states are discouraged from adopting
this more efficient method of eligibility determination and redeterminations. Making
ELE permanent would support states that have already adopted the policy; in addition,
ELE could support the transition of children to Medicaid or exchanges should CHIP
not be funded after September 30, 2015.
Keywords
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Article info
Publication history
Published online: March 30, 2015
Accepted:
February 19,
2015
Received:
November 4,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
