Express Lane Eligibility and Beyond

Automated enrollment strategies have achieved remarkable results with a range of public and private benefit programs, dramatically increasing program participation while lowering ongoing operating costs and reducing erroneous eligibility determinations. The recently passed Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) should make such steps much easier for states to take in helping eligible but uninsured children obtain and retain health coverage.

After describing relevant provisions in CHIPRA, this paper explores the potential use of automated strategies to achieve four goals:

  • Identifying uninsured children;
  • Determining their eligibility for Medicaid and the Children’s Health Insurance Program, or CHIP (formerly called “the State Children’s Health Insurance Program,” or SCHIP);
  • Enrolling eligible children into coverage; and
  • Retaining eligible children.

Authored by Urban Institute researcher Stan Dorn in collaboration with the National Academy for State Health Policy (NASHP), the paper catalogs options that states could consider. No state would do everything described here.