Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey


January 2016 marks the second anniversary of the effective date of the Affordable Care Act’s (ACA’s) key coverage provisions. During 2015, Medicaid and CHIP continued to be central sources of coverage for low-income children and pregnant women nationwide, and Medicaid’s role for low-income adults grew as a result of the ACA Medicaid expansion. At the end of the second full year of implementation of the ACA’s coverage expansions, states have continued to implement and enhance new and upgraded eligibility and enrollment systems that underpin the ACA’s vision for a modernized data-driven enrollment experience. States also worked to implement automated renewal processes and improve coordination between Medicaid and the Marketplaces, resolving many problems and delays faced during the initial year of ACA implementation.

This annual report presents Medicaid and CHIP eligibility, enrollment, renewal and cost-sharing policies based on a survey of state program officials. It provides a point-in-time snapshot of policies in place as of January 2016 and identifies changes in state policies that occurred between January 2015 and 2016. These changes provide insight into how state policies are evolving from the new baseline that was established at the end of 2014, after the first full year of ACA implementation. State-specific information is available in Tables 1 to 21 at the end of the report.

Executive Summary Medicaid and CHIP Eligibility

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