The Target Efficiency of Online Medicaid/CHIP Enrollment

An Evaluation of Wisconsin's ACCESS Internet Portal

Wisconsin’s Department of Health Services reports that more than 60 percent of all applications for BadgerCare Plus—a combined Medicaid and Children’s Health Insurance Program (CHIP)—now come through ACCESS, the state’s online application system for health coverage and other public benefits. Through a recent large-scale expansion of health coverage eligibility, ACCESS has seen success in enrolling users into public programs with relative ease of use. The Web-based, self-service tool allows applicants to see if they are eligible for benefits through BadgerCare Plus, apply for benefits, check their benefit renewal date, and more. As states nationwide create automated online processes to facilitate enrollment in Medicaid and the new health insurance exchanges under the Affordable Care Act (ACA), the success of ACCESS may provide informative lessons about both the significant potential benefits, but also the limitations of technology-based enrollment systems.

This brief from the State Health Access Reform Evaluation (SHARE) initiative, funded by the Robert Wood Johnson Foundation (RWJF), examines which socioeconomic groups are likely to apply for benefits via an online system like ACCESS versus traditional means, and also the relative success of the online system in attracting applicants who are ultimately eligible for the program. Lead author Donna Friedsam, M.P.H., of the University of Wisconsin Population Health Institute, finds that a well-designed, easily accessible online enrollment system can encourage high program take-up, though remains uneven across demographic subgroups with lower income, rural, non-English speaking populations least likely to use the system.