State Experiences with Express Lane Eligibility

Policy Considerations and Possibilities for the Future

The following document, prepared by the National Academy for State Health Policy for RWJF's State Health Reform Assistance Network, discusses the possible role of Express Lane Eligibility (ELE) in simplifying and streamlining enrollment into Medicaid and the Children’s Health Insurance Program (CHIP). Originally enacted as an enrollment simplification strategy for CHIP, ELE gives states the opportunity to use existing results from other means-tested human services programs to determine eligibility for Medicaid and CHIP. This helps states to not only identify individuals already known to the systems, but also reduces the documentation burden on both families and the state.

Based on the state interviews conducted for this brief, many of the states using ELE today are interested in continuing to operate the strategy to simplify enrollment and retention for children and want to expand it to be used for adults into and beyond 2014. The following brief outlines important elements of ELE and uses state-specific case studies as evidence for its effectiveness.