Automatic for the People: Enrolling Smarter, Faster, and Cheaper in Louisiana

By Guest Blogger

These beignets at Cafe Du Monde are covered, and so are thousands more children thanks to Louisiana’s enrollment policies!

This week, just in time for Mardi Gras, Louisiana-bellwether state for enrollment improvements extraordinaire-gives us something else to celebrate. A new report from the Urban Institute finds that automating children’s enrollment and renewal saved Louisiana between $8 and $12 million (million!) in the first year alone.

How has Louisiana done it? First, let’s take a quick trip down memory lane. The legislation reauthorizing CHIP in 2009 included a new option allowing states to automate children’s enrollment or renewal, fondly referred to as Express Lane Eligibility, since it puts children on a fast track to enrollment.

There are lots of different ways that states can do Express Lane Eligibility, but here’s the basic gist: A key factor in determining Medicaid or CHIP eligibility is a family’s income. Instead of requiring a family to apply separately for health coverage, the state can look at records it already has about the family’s income from other programs, like the Supplemental Nutrition Assistance Program (SNAP) or Free and Reduced Price Meals. Express Lane Eligibility allows the state to rely on the verification procedures and income methodology of other federal programs that are designed for low-income people to determine whether or not the children in the family are eligible for Medicaid or CHIP. And in so doing, it can automatically enroll eligible children in health coverage, without requiring them to fill out additional paperwork. The same goes for renewing coverage. If the available data show that the children continue to be eligible based on their records from other programs, the state can renew their coverage for another year without making the family to do a thing.

Louisiana’s story

  • In 2009-2010, Louisiana started using Express Lane Eligibility for children’s Medicaid enrollment and renewal by connecting with SNAP records. In the first year alone, this method allowed the state to enroll more than 20,000 children and renew coverage for more than 156,000 children.
  • And not only did this get a large volume of children enrolled quickly (and keep them enrolled), it also saved the state a bundle. It costs Louisiana $116 to manually enroll a child in Medicaid, and $76 to manually renew that coverage. The state spent just under $600,000 to update its IT systems to handle automated enrollment and renewal, and now it costs just $12 to $15 to automatically enroll a child. And automated renewal costs absolutely nothing (!). If the data show that a child is receiving SNAP benefits, his or her Medicaid coverage is automatically renewed.
  • Factoring in the up-front IT investment, Louisiana saved between $8.4 and $12.8 million during the first 12 months these policies were in place, compared to what manual enrollment would have cost.

So what does it all mean? Millions of Americans will be newly eligible for coverage less than two years from now. Getting them in-and keeping them in-quickly and efficiently is eminently possible if states learn from Louisiana’s early efforts and put the policies and systems in place to support automated enrollment. Automating enrollment and renewal isn’t just something states should do-it’s something they can’t afford not to do.

As for Louisiana, Laissez les bons temps rouler…or should that be “en”rouler?


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