Amid ongoing state budget pressures, a requirement in the Affordable Care Act (ACA) that states maintain eligibility in Medicaid and CHIP was central in preserving coverage during 2011. In addition, more than half of states (29) made improvements in their programs. Most of these improvements involved greater use of technology to boost program efficiency and make it easier for families to enroll in coverage, but 11 states adopted targeted eligibility expansions, primarily for children.

This annual 50-state survey on eligibility, enrollment, renewal, and cost sharing policies also found that the new enhanced federal funding for technology investments spurred state action to modernize Medicaid eligibility systems. During 2011, a diverse majority launched major system improvement projects that will utilize this new funding to make far-reaching changes to their existing eligibility systems and move the enrollment and renewal process into the 21st century.

Other versions of the 50-state survey on eligibility, enrollment, renewal, and cost sharing were published in January 2017, January 2016, January 2015, November 2013, January 2013, and January 2011.