ELE applications for initial enrollments take less staff time than the traditional application process in all states except Maryland, where ELE saves no time. Figure III.3 shows that the time savings range from fewer than 5 minutes per application in Alabama, to more than 30 minutes in Louisiana. For Iowa Medicaid, Louisiana, and New Jersey, ELE reduces the time to process an application by more than half relative to the traditional process. These time savings translate into cost savings to the public sector of $1 per successful ELE application for Alabama, $8 for Oregon, $15 for Louisiana, and $16 for Iowa Medicaid.
Figure III.3. Time Saved Processing an ELE Application Compared to a Standard Application
Source: Mathematica analysis of interviews and follow-up correspondence with state staff between January and June 2012.
ELE = Express Lane Eligibility.
Alabama and Louisiana also save time on renewals processed via ELE. In Louisiana, ELE renewals are fully automated, so each ELE renewal saves 21 minutes. This translates to a saving of approximately $10 per renewal. In Alabama, each renewal done via ELE saves fewer than five minutes, translating to a saving of just under $1 per renewal.
Figure III.4 shows the value of annualized time savings from processing applications and renewals through ELE rather than the traditional routes. Louisiana saves much more than Oregon and Iowa Medicaid—nearly $2,000,000 per year—primarily because of the volume of cases it processes using ELE (Louisiana processes 11,000 applications and 180,000 renewals compared to 3,800 applications for Oregon and 1,300 applications for Iowa Medicaid). Alabama processes approximately 27,000 ELE applications and 67,000 renewals per year, but because the ELE process currently saves staff little time, Alabama’s annual savings from ELE applications and renewals are much lower than Louisiana’s.25 In New Jersey, the state’s third-party contractor absorbs the value of the time savings, since their contract was not modified to account for ELE. Thus, the value of time saved is shown as zero dollars.
25 State administrative data were not able to capture the number of ELE renewals that have taken place in Alabama. State staff estimated 200,000 children had been processed using ELE from October 2009 through December 2011, and administrative data analyzed by Mathematica showed that approximately 50,000 of these were initial applications. We have, therefore, assumed that 150,000 renewals were processed using ELE in Alabama up to December 2011.