Since 2008, the Maryland Department of Health and Mental Hygiene (DHMH), which administers the Medicaid program, has partnered with the Office of the Comptroller (the state taxation agency) to conduct outreach to tax filers whose children are potentially eligible for Medicaid. The state income tax form includes a box for families to check to indicate whether their dependents have health insurance. The Comptroller’s office sends a streamlined Medicaid application form—with fewer reference pages and no questions on immigration status—to families with incomes below 300 percent of the Federal poverty level (FPL), as shown on their tax returns, who indicate they have uninsured dependents.
CMS recognized Maryland’s process as an ELE program effective April 2010, after the state modified its procedures to use tax filings to establish state residency. Specifically, returning the streamlined application mailed by the Comptroller is accepted as evidence of state residency, as it signifies the family’s prior filing of a state income tax return; for standard applications, residency is confirmed by consulting a state database. Otherwise, application processing for ELE and standard routes is currently the same. Through the use of 2009 tax return data, in 2010 just over 150,000 letters were sent to potentially eligible families, yielding an unknown number of enrollments.16
Maryland has plans for data-sharing and enhanced data-matching processes that will change the ELE process. A recent Memorandum of Understanding between the Comptroller and DHMH will allow the Comptroller to provide tax return information to DHMH starting in 2012. DHMH will match the Comptroller’s database against its own database of existing Medicaid recipients, enabling more targeted mailings. DHMH is also considering the use of income information provided on tax returns for determining Medicaid income eligibility.
16 The state does not track which enrollments resulted from ELE compared to standard applications.