Panel: Evaluating Express Lane Eligibility

Saturday, November 10, 2012: 8:30 AM-10:00 AM
Mencken (Sheraton Baltimore City Center Hotel)

*Names in bold indicate Presenter

Organizers:  Sean Orzol, Mathematica Policy Research
Moderators:  Thomas Buchmueller, University of Michigan
Chairs:  Milda Aksamitauskas, State of Wisconsin

In the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Congress gave states the option to implement Express Lane Eligibility (ELE). ELE allows public insurance agencies to use data already acquired by other agencies, rather than collecting and verifying information independently. ELE could expedite enrollment of some of the nation’s five million uninsured children into public coverage programs for which they are eligible in a cost-effective manner, allowing policymakers and public managers to do more with fewer resources. Beyond administratively easing children’s enrollment in public coverage, ELE holds potential as a mechanism to help states comply with Affordable Care Act (ACA) requirements. For example, under ACA, whenever possible, eligibility must be established, verified, and renewed based on matches with reliable data sources. A rigorous evaluation of current ELE programs will thus provide a valuable evidence base for future policy development. In addition, the ELE evaluation will give policymakers insights about progress and challenges in data sharing between and among state agencies. For example, lessons from Supplemental Nutrition Assistance Program (SNAP)-based ELE programs might be useful for states seeking to reduce their administrative burdens by prequalifying low-income adults who will be newly eligible for Medicaid in 2014. To assess the degree to which ELE has enabled administrative efficiencies, the first paper uses data from interviews with program administrators in six ELE states to explore ELE implementation and implementation costs; the differences in ongoing costs between ELE and standard enrollment routes; and the perceived benefits to enrollees and the state. Along with costs, the effect on children’s enrollment into CHIP and/or Medicaid is the main standard by which to judge ELE programs. The second paper uses administrative data from five states to examine ELE enrollment in Medicaid and CHIP, considering how many children have enrolled via ELE, and the influence of ELE on enrollment growth rates; whether ELE enrollees are different from other enrollees; and whether ELE enrollees are more or less likely to stay enrolled. The final paper uses the Statistical Enrollment Data System (SEDS) to assess enrollment trends in ELE states, compared with those in non-ELE states, which serve as a counterfactual against which to assess changes in ELE states, and their causal links to ELE adoption. This assessment accounts for confounding policy changes or trends in ELE states that could be driving enrollment gains and might otherwise bias analyses of ELE enrollment. Contribution: This panel includes studies drawn from the first full, multi-state evaluation of ELE, sponsored by the Assistant Secretary for Planning and Evaluation (ASPE). Members of the ELE evaluation team from Mathematica Policy Research and the Urban Institute will share their preliminary findings on cost and enrollment. Tom Buchmueller, a senior health economist on the President’s Council of Economic Advisors and a professor at the University of Michigan, will discuss the studies and offer insights on the implications of ELE for ACA. This session should be of interest to a broad cross-section of APPAM members, including policy makers, researchers, evaluators and program administrators.

More with Less: Express Lane Eligibility's Potential to Improve Administrative Efficiency
Margaret Colby, Adam Swinburn and Sean Orzol, Mathematica Policy Research

Expanding Coverage Using Express Lane Eligibility: Analysis of Administrative Data From Five States
Sean Orzol, Adam Swinburn and Margaret Colby, Mathematica Policy Research

The Effects of Express Lane Eligibility On Enrollment: Analysis of the Statistical Enrollment Data System
Fredric Blavin1, Genevieve Kenney1 and Michael Huntress2, (1)Urban Institute, (2)The Urban Institute

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