CHIPRA Mandated Evaluation of Express Lane Eligibility: First Year Findings. V. Summary of First-year Evaluation Findings


Building on research efforts demonstrating that enrollment and retention simplification policies could lead to coverage gains for children and potential efficiency gains for states and the Federal government, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) offered states new policy options, and new incentives, to try to find, enroll, and retain eligible children. This report has focused on one of the new options CHIPRA afforded to states—Express Lane Eligibility (ELE)—which permits states to use findings from other public agencies to determine Medicaid or Children’s Health Insurance Program (CHIP) eligibility.

In this chapter, we discuss interim results from the evaluation’s first year. The findings presented in this report should be considered tentative; because ELE is so new and so varied in its potential uses, and its implementation has been limited to a handful of states, it is too soon to draw conclusions about its effects on administrative costs or enrollment. In many instances, we need the second-year evaluation activities to assess the robustness of findings from this first year and to further elucidate the reasons behind, and meaning of, most of them. In addition, although this report looks at ELE’s implementation, ELE might have differential long-term effects. For example, as ELE processes mature, the costs and savings that accrue to states could change. The second-year evaluation activities will provide a longer post-implementation period and offer more extensive data to assess both short- and long-term policy effects. We also will be better able to distinguish between inherent features of ELE and issues that arise based on particular state choices about how to implement this new option.

Next, we discuss first-year findings and their implications for administrative costs, enrollment, processes, and policies. We finish with a discussion of future evaluation work and how it will extend the findings from the first year.

View full report


"rpt.pdf" (pdf, 1.1Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®