President Obama’s fiscal year 2016 budget would wisely enable states to cut red tape and enroll more eligible children and adults in Medicaid and the Children’s Health Insurance Program (CHIP) by making permanent Express Lane Eligibility (ELE) for children and letting states extend Continuous Eligibility (CE) to adults.
ELE, which is slated to expire at the September 30 end of fiscal year 2015, gives states the option to use the information they’ve already collected and verified to establish eligibility in other programs such as SNAP (food stamps) to streamline enrollment of eligible children into Medicaid and CHIP. ELE can boost enrollment and reduce administrative costs, according to a recent Government Accountability Office report and a federal evaluation by Mathematica Policy Research.
The President’s budget also proposes to let states provide continuous Medicaid coverage of up to 12 months to adults — which is already an option for children, and which about half of states take up in their Medicaid and/or CHIP programs.
In Medicaid, once individuals are found eligible, they must generally report any change that may affect their eligibility during the year and states must act on these changes. That’s especially hard for Medicaid beneficiaries and state agencies because peoples’ incomes often fluctuate over the course of a year, sometimes even month to month. Thus, beneficiaries may have to switch back and forth between Medicaid and subsidized marketplace coverage under health reform, and they may experience coverage gaps if the paperwork proves overly burdensome and too difficult to complete.
Moving beneficiaries back and forth repeatedly between Medicaid and the marketplace is costly for state Medicaid agencies, for marketplaces, and for health plans, and it may cause disruptions in care for Medicaid beneficiaries. As it has for children, continuous eligibility for adults would avoid this unnecessary paperwork and any resulting coverage gaps.