This document discusses strategies for enrolling eligible individuals in Medicaid and CHIP programs, including the use of Express Lane Eligibility (ELE) which allows eligibility determinations using data from other agencies. It provides three examples of how ELE could work using state income tax forms, food stamp program data, and national school lunch program data. It also summarizes Massachusetts' approach to determining eligibility and enrolling residents using an integrated system and automated processes.
Innovative strategies to enroll eligible people into Medicaid and CHIP
1. Innovative strategies to enroll eligible people into Medicaid and CHIP SCI National Meeting Albuquerque, NM Stan Dorn The Urban Institute [email_address] 202.261.5561 July 30, 2009
8. First example of ELE: state income tax forms CHIPRA specifically authorizes ELE based on gross income or adjusted gross income shown on state income tax returns and records
9. Uninsured children who qualify for Medicaid or CHIP, by legal requirement to file federal income taxes and eligibility for federal EITC: 2004 Source : Dorn, et al., Feb. 2009.
10. Among various groups of uninsured children, the estimated percentage whose families filed federal income tax returns: 2004 Sources : Dorn, et al., Feb. 2009.
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15. Second example of ELE: food stamps Note: Food stamps has been officially renamed the Supplemental Nutrition Assistance Program, or SNAP
21. NSLP-recipient children, by type of NSLP benefit and income-eligibility under standard Medicaid and CHIP rules (based on audited family income) Source : Dorn, April 2009. Children receiving free school lunches Children receiving reduced-price school lunches Income-eligible for Medicaid 81% 49% Income-eligible for CHIP 14% 38% Income too high for both programs 4% 13% Total: 100% 100%
22. Part II. Eligibility determination and enrollment in Massachusetts Preliminary findings from a SHARE grant funded by the Robert Wood Johnson Foundation
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24. Net increase in the number of Massachusetts residents with health insurance, by coverage type: 6/30/06 to 9/30/08 Source: Massachusetts Division of Health Care Finance and Policy, February 2009.
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