Overcoming Interagency Data-Sharing Barriers

Lessons from the Maryland Kids First Act

States are finding it increasingly difficult to identify and enroll uninsured children who qualify for Medicaid or the Children’s Health Insurance Program (CHIP)—particularly given increasingly severe recessionary budget limitations. Yet the CHIP Reauthorization Act of 2009 offers financial incentives for states to enhance and simplify their application and renewal processes.

Three states—Iowa, Maryland and New Jersey—have pioneered the use of state income tax information to do just that by targeting eligible families more effectively and efficiently. This report, released by the Hilltop Institute at the University of Maryland, Baltimore County (UMBC) and funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) initiative, provides an overview of how the various strategies implemented under Maryland’s Kids First Act may be informative for others nationwide.

Beginning in September 2008, Kids First notices were sent to Maryland taxpayers with household incomes meeting Medicaid/MCHP eligibility standards. The result was that more than 30,000 previously uninsured children in Maryland secured coverage through Medicaid or MCHP. In the years that followed, interagency communications improved—including permission for the state Comptroller’s office to share taxpayer information with the Department of Health and Mental Hygiene, Maryland’s Medicaid agency. Also, questions on the state’s income tax form were refined to better assess whether children had health insurance versus access to health care, and whether they were under 19 years of age.

Like Maryland’s Kids First legislation, the Affordable Care Act includes provisions designed to make federal tax information available for use in state Medicaid/CHIP outreach—meaning Maryland’s lessons may soon prove instructional across the country.