CHIPRA Mandated Evaluation of Express Lane Eligibility: First Year Findings. 2. Research Questions Addressed by This Report and Data Sources Used to Answer Them


This interim Report to Congress details findings from the first two components of the evaluation completed in 2012: (1) the descriptive analysis of costs in six ELE states and the descriptive analysis of enrollment in four of those ELE states, and (2) the analysis of the impact of ELE on enrollment in Medicaid and CHIP programs. Table I.3 describes the key research questions each of these components addresses.

Table I.3. Key Research Questions Addressed in This Report

Study Component Key Research Questions Addressed Through First-Year Evaluation Activities
Descriptive Study of Administrative Costs and Enrollment
  • How has ELE been implemented?
  • How are ELE programs similar and different across states?
  • What are the up-front investment costs associated with implementing ELE?
  • What are the marginal savings or costs to the state from processing an application or renewal using ELE, rather than the traditional mechanism?
  • How many children are enrolled through ELE – both upon initial implementation and on an ongoing basis? 
  • Do children who enter Medicaid and CHIP through ELE stay enrolled as long as children who enroll through standard pathways?
  • Within a state, how do the demographic characteristics of enrollees who enter through ELE compare with those of children who enroll through standard pathways? 
  • Have enrollees who enter through simplified approaches to enrollment ever been Medicaid or CHIP beneficiaries in the past? 
Impact Analysis Using SEDS Data
  • Does the implementation of ELE have a positive effect on Medicaid/CHIP enrollment? If so, how large are the enrollment gains?
  • Are enrollment effects similar across different types of ELE programs?
  • To what extent are enrollment effects robust within the subset of states that implemented ELE?
  • If there are positive enrollment impacts, do they appear to be sustained over time?

CHIP = Children’s Health Insurance Program; ELE = Express Lane Eligibility; SEDS = Statistical Enrollment Data System.

This report includes data collected through primary data collection efforts and from secondary sources. As described in more detail in Chapters II and III, researchers interviewed state staff in six ELE states (Alabama, Iowa, Louisiana, Maryland, New Jersey, and Oregon) between January and March 2012 to collect information on their ELE programs and processes and to assess the administrative costs of ELE implementation. For the descriptive analysis of new enrollment in these states (conducted in all of the states except Maryland and Oregon), state staff populated aggregate table shells (although in two states, Alabama and Louisiana, we were able to obtain access to individual-level data on which to base the analyses). For the analysis of the impact of ELE on enrollment, we used data from SEDS, a reporting system maintained by CMS since 2000 that collects new and total Medicaid and CHIP enrollment data from states on a quarterly basis, as well as other secondary data sources to support the multivariate analysis, including data from the Bureau of Labor Statistics, U.S. Census Bureau, and Kaiser Family Foundation. Chapter IV further describes methods and includes a complete list of secondary sources for the impact analysis.

Finally, we used published and unpublished literature on CHIP, CHIPRA, and ELE to supplement the main data sources and to provide motivation and context for the findings in each chapter. Sources include SPAs, ELE and standard application forms, and state budget and performance reports.

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