In our discussions with administrators, several themes emerged about what factors facilitated ELE process improvements. Among them, states should think carefully about their selection of a viable Express Lane agency partner: it is a critical first step in the ELE process. First-year findings do not suggest that partnering with a certain type of agency—such as SNAP, TANF, Medicaid, or state tax agency—makes cost savings or enrollment gains more likely. Rather, it is likely tied to the processes for using partner agency information and whether that agency has data on large numbers of eligible-but-uninsured children or enrolled children up for renewal. States might consider “test” data matches with potential partners to understand how ELE might function in practice. For example, besides partnering with SNAP and TANF, Alabama considered an ELE partnership for its CHIP program with the state’s child care subsidy program because the income eligibility levels for both programs are similar. Through a test data match, Alabama administrators found that few eligible children were identified through the child care subsidy program, and that, given its older information systems, the costs of the systems changes that would be needed far outweighed the potential gains to coverage.
State administrators also said it was easier to implement ELE processes when they could build upon existing relationships, because of the familiarity with agency staff and their operations, as well as the existence of data use agreements that could easily be modified to accommodate ELE. Of the seven ELE programs studied as part of the qualitative analysis, six chose an Express Lane partner with which they had a prior data-sharing relationship.
Finally, in states where the ELE process uses partner agencies’ findings as a means to target application mailings, we find far fewer ELE-linked enrollments. These more tepid findings suggest that this outreach-focused approach to ELE, which requires parents to respond to mailings, may offer less promise as a means for enrolling large numbers of new children.