Building an Express Lane Eligibility Initiative: A Roadmap of Key Decisions for States

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provides states new options to reach and enroll the estimated 5 million eligible but uninsured low-income children into Medicaid and CHIP. One key tool provided to states by the law is Express Lane Eligibility (ELE), which allows state Medicaid and CHIP agencies to borrow and rely on eligibility findings from other need-based programs, such as Head Start and the National School Lunch Program, to determine and/or renew Medicaid or CHIP eligibility for children.

Under the ELE initiative, Congress gives states significant flexibility to design and build enrollment and retention initiatives that meet their unique needs. Thus, in designing an ELE initiative, there are a number of key decision points a state will face. This brief, the third in a new series called Putting Children on the Express Lane to Health Insurance, provides an overview of those key decisions that a state will need to address.

Issue Brief (.pdf)