State Use of Express Lane Eligibility for Medicaid and CHIP Enrollment

Medicaid and the Children's Health Insurance Program (CHIP) provide health insurance coverage for certain low-income children, yet millions of eligible children are still uninsured. To increase enrollment of eligible children, Congress authorized States to adopt the Express Lane Eligibility (ELE) option, which allows States to expedite and simplify enrollment in Medicaid and CHIP by relying on findings from other agencies' eligibility determinations. Congress will determine whether to reauthorize the ELE option in 2017. We conducted this study in response to a Congressional request that the U.S. Department of Health and Human Services, Office of Inspector General (OIG) examine the benefits and barriers to State use and expansion of ELE. This report is being issued concurrently with two OIG audits that fulfill a Congressional mandate to assess whether State agencies met Federal requirements in making eligibility determinations using ELE and developing eligibility error rates.