By Donna Cohen Ross, Center on Budget and Policy Priorities
All in one night — February 11 — 10,484 eligible children
were enrolled into Louisiana’s Medicaid program.
Are you trying to imagine this? If so, you’re probably
picturing mile-long lines of children winding through Baton Rouge, parents in
tow, clutching packets of forms and documents. A winter storm warning is in effect — so said the Baton
Rouge newspaper that day — and freezing rain is already pelting the city, with
an accumulation of 1 to 2 inches of snow expected overnight. The crowd of
babies and toddlers, tweens and teens, and thousands of others are just
waiting, waiting, waiting. You’re
thinking this is an ill-advised stunt.
Can’t be done. Not even
with every eligibility worker plugging away, all night, nonstop. Not even with
every family equipped with every bit of paperwork in hand, exactly in order. No
way. Your anxiety level is out of control just thinking about it.
If this is where your imagination has taken you,
relax. What really happened in
Baton Rouge that night took place calmly and efficiently while those thousands
of children, families and eligibility workers were fast asleep. What really happened was that 10,484
children got enrolled in one fell swoop through a new CHIPRA option called
Express Lane Eligibility.
All together, in one night … done! And they did it using findings from the
Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp
Program, to determine Medicaid eligibility. Make no mistake, however. Louisiana officials didn’t just snap their fingers. It took
many months of careful planning and preparation — and coordination with the
separate agency that administers SNAP in Louisiana — to be sure the process
would substantially ease enrollment and at the same time preserve program
Here’s how it worked: State officials started with the
knowledge that children who qualify for SNAP are in families with income that
meets the test for Medicaid, and a significant proportion are likely to be
uninsured. A file containing
all children receiving SNAP benefits was transferred electronically from the
computer system at the Department of Social Services to the computer system at
the Department of Health and Hospitals, where Medicaid resides. Children
already on Medicaid were removed.
The remaining file of children receiving SNAP but not Medicaid provided
income findings, as determined based on food stamp rules, as well as the
children’s Social Security numbers, residency and age.
Under Express Lane there is no need to recalculate income
using Medicaid rules. So, these “borrowed” findings are used, along with other
necessary information obtained from available data bases (such as U.S.
citizenship from the Social Security data base) to determine Medicaid
eligibility and enroll the children.
Next, Medicaid cards and decision notices were mailed to
the families. At that point, they were informed that the last step in this
process — affirming they want to enroll their child in Medicaid — would happen
the first time they use the card to see a doctor or fill a prescription.
Ruth Kennedy, Louisiana’s Medicaid Deputy Director,
explains the significance of the February 11th feat: “Express Lane Eligibility is a huge administrative
efficiency and takes advantage of 21st century technology. It demonstrates that
we can reduce duplication of effort when government agencies work
together.” Ruth says that the
state will be monitoring the system to refine the process and make sure that
children enrolled through Express Lane are using their health care benefits — a
sign that the new system really works.
Going forward, she anticipates that SNAP findings will be used to
automatically enroll children in Medicaid when they are determined eligible for
food assistance. Isn’t this just
the kind of coordination Secretary Sebelius and Secretary Vilsack were talking
about when they joined together to celebrate the first anniversary of CHIPRA
So, are you still visualizing those 10,484 children
standing in line with their families to gain access to health benefits? Erase that image and instead picture
them avoiding unnecessary ER visits, getting critical preventive care, medical
treatment and the prescription medications they need. Nice picture, huh?
Not bad for a night’s work!