By Kristen Golden Testa, The Children’s Partnership
Imagine your infant has a high fever and you want to bring her to the doctor but don’t have health insurance. Or your young child can’t concentrate at school due to a tooth ache and you can’t afford to go to the dentist without coverage. Now imagine, one day you get a letter in the mail saying that with just your OK, your child can be enrolled in the State’s health insurance program that offers free comprehensive health and dental benefits and no application! What a wonderful Valentine’s gift!
It seems too good to be true. You might think it is just an advertisement, but no, it is legitimate! And it is actually happening in California. California and a few other states have taken up the federal option to offer “express enrollment” for individuals who are currently enrolled in SNAP—or CalFresh in California. Here is how it works: if an individual is enrolled already in CalFresh, the State can use that eligibility information to enroll them in Medi-Cal (California’s Medicaid program). No additional application. Since the eligibility rules and income levels are very similar between CalFresh and Medi-Cal, a CalFresh enrollee is also eligible for Medi-Cal.
Because California also took up the ACA Medicaid expansion, the State wanted to use this express enrollment strategy to quickly identify and enroll the newly eligible adults. California identified about 550,000 adults who receive CalFresh, but are not enrolled in Medi-Cal.
The added bonus is that the State has decided to provide express enrollment to those children who are enrolled in CalFresh but not yet enrolled in Medi-Cal. The State identified 153,000 CalFresh children who are not yet enrolled in Medi-Cal. As a children’s health advocate, that number almost takes my breath away: That is about 3 Dodger Stadiums full of children! While these children were already eligible for Medi-Cal even prior to the ACA, express enrollment is a tremendously efficient strategy for identifying, reaching, and enrolling many uninsured children in California.
With much of the media coverage focused on troubles with ACA enrollment, express lane enrollment is a good news story about a smart enrollment policy that should not be missed. By using the eligibility information already available, hundreds of thousands of Californians can gain no-cost coverage by just saying ‘yes’ to health insurance!
The federal express lane opportunity for adults is time limited. It is only provided to jump start enrollment of those newly eligible as a result of the ACA. Express Lane Enrollment was originally created for children’s enrollment, linking health insurance enrollment to a multitude of children’s programs with similar eligibility rules, such as SNAP, WIC, and school lunch. Many states have had great success in enrolling eligible children in health insurance using Express Lane Enrollment and have saved millions of dollars as a result of the program efficiencies. A recently released evaluation of Express Lane found that states were able to reach and enroll many uninsured children and did so while maintaining extremely low error rates and saving millions in program administrative costs.
However, federal authority for Express Lane Enrollment expires in just seven months, in September 2014. While the federal Centers for Medicare and Medicaid Services could grant waivers to states to continue their Express Lane Enrollment projects, without the federal authority renewed, interested states may hold off on adopting or expanding this enrollment approach until the authority is certain.
Express enrollment is about to improve the lives of thousands and thousands of California families, right in time for Valentine’s Day. Making Express Lane Enrollment permanent would allow California and other states to continue to work smarter, not harder, in enrolling children and families in health coverage.