Express Lane Eligibility and Beyond: How Automated Enrollment Can Help Eligible Children Receive Medicaid and CHIP

Executive Summary Expr Ess LanE E Ligibi Lity and bEyond • poLicy o ptions rEport 1Stan DornSenior Research AssociateThe Urban InstituteHealth policy centerApril 2009a catalog of state policy optionsExpress Lane Eligibility and Beyond: How Automated Enrollment Can Help Eligible Children Receive Medicaid and CHIP Expr Ess LanE E Ligibi Lity and bEyond • poLicy o ptions rEport 2About the author Stan Dorn is a senior research associate at the Urban Institute. For nearly 25 years, he has worked at the state and federal level on health insurance coverage for low-income children and families. A former Senior Policy Analyst at the Economic and Social Research Institute, Managing Attorney at the National Health Law Program, and Health division director at the children’s defense Fund, Mr. dorn is widely viewed as one of the nation’s leading experts on auto-enrollment strategies for uninsured children and adults. About the Urban Institute’s Health Policy Centerthe Urban institute is a nonprofit, nonpartisan policy research and educational organization that examines the social, economic, and governance problems facing the nation. the i nstitute’s Health policy c enter (Hpc ) analyzes trends and underlying causes of changes in health insurance coverage, access to care, and use of health care services by the entire Us population. researchers address issues that arise from the inevitable trade-offs among health care costs, access, and quality. For more information, see the Hpc website, www.urban.org/health_policy, or the Urban institute’s more general website, www.urban.org. About the National Academy for State Health Policythe n ational academy for state Health policy ( nas Hp) is an independent academy of state health policy makers working together to identify emerging issues, develop policy solutions, and improve state health policy and practice. as a non-profit, non-partisan organization dedicated to helping states achieve excellence in health policy and practice, nas Hp provides a forum on critical health issues across branches and agencies of state government. nas Hp resources are available at: www.nashp.org. nasHp serves as the national program office for the robert Wood Johnson Foundation’s initiative, “Maximizing Enrollment for Kids.” information is available at www.maxenroll.orgAbout the Robert Wood Johnson Foundationthe r obert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. as the nation’s largest philanthropy devoted exclusively to improving the health and health care of all americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful, and timely change. For more than 35 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.Acknowledgementsthe author thanks the robert Wood Johnson Foundation for providing the funding that made this research possible. in addition, the author thanks the national academy for state Health policy ( nas Hp) and catherine Hess, NASHP Senior Program Director, for convening a December 2007 meeting to discuss automated enrollment strategies that informed development of this paper. the participants at that meeting, including state officials from across the country as well as leading national experts, gave generously of their insights and experience. the author appreciates the helpful advice and suggestions of genevieve Kenney of the Urban institute; patricia Mactaggart of g eorge Washington University; Eileen Ellis and theresa sachs of Health Management associates; catherine Hess, neva Kaye, and alice Weiss of the national academy for state Health policy ( nas Hp); s andra shewry of the c alifornia department of Health services; beth Morrow of the c hildren’s partnership; Lynn Etheredge of the george Washington i nstitute for Health p olicy; d awn Horner of the g eorgetown University c enter for c hildren and Families; and Jennifer ryan of the national Health policy Forum. the author further thanks his Urban institute colleagues who analyzed the relationship between Food stamp receipt and health coverage, including Kenneth Finegold and paul Johnson, who worked with the transfer income Model, Version 3 (tri M3), and allison cook, who provided cps estimates of coverage; Ms. cook also helped in the analysis of nsLp receipt and eligibility for Medicaid and children’s Health insurance program. the author is also grateful to the staff at Mathematica, inc., including Michael ponza, Lara Hulsey, and tim n ovak, who compiled and provided unpublished data about