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Accession Number PB2013-103449
Title Medicaid and CHIP: Considerations for Express Lane Eligibility.
Publication Date Dec 2012
Media Count 16p
Personal Author N/A
Abstract Each year, millions of children do not have health insurance coverage even though they are eligible for Medicaid or the Children's Health Insurance Program (CHIP), two joint federal-state programs that provide health insurance to certain low-income individuals. Additionally, each year, some children lose Medicaid or CHIP coverage for which they are eligible and then, after a short coverage gap, reenroll--a process that is costly to the programs administratively, as well as burdensome for families. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provided states with new incentives and tools to simplify eligibility determinations and increase the enrollment and retention of children in Medicaid and CHIP. One of these tools is Express Lane Eligibility (ELE), which allows states to determine eligibility for children in Medicaid or CHIP by using certain information, such as information from other public-assistance programs that enroll children. Specifically, within certain limits, ELE allows a state Medicaid or CHIP agency to use another entity's findings--in other words, determinations of fact, such as the family's income--when evaluating a child's eligibility for Medicaid or CHIP, as long as those findings were made within a reasonable period. These other entities, called Express Lane Agencies, are defined to include public agencies that determine eligibility for certain assistance programs, such as the National School Lunch Program, the Supplemental Nutrition Assistance Program (SNAP, formerly called the Food Stamp Program), the Temporary Assistance for Needy Families program (TANF), and Head Start. Under ELE, a state Medicaid or CHIP agency may rely on an Express Lane Agency's findings even if the Express Lane Agency uses a different method than Medicaid or CHIP to derive those findings.
Keywords Children
Children's Health Insurance Program(CHIP)
Express Lane Eligibility(ELE)
Federal assistance programs
Health insurance
Health services
Low income groups
Social services
State programs

Source Agency General Accounting Office
NTIS Subject Category 92C - Social Concerns
44B - Agency Administrative & Financial Management
43C - Human Resources
70F - Public Administration & Government
Corporate Author Government Accountability Office, Washington, DC.
Document Type Technical report
Title Note N/A
NTIS Issue Number 1308
Contract Number N/A

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