By Martha Heberlein

In case you missed it, it was a beautiful day in Washington on Friday and some exciting news from CMS made the day all the brighter – a State Health Official letter they released provides states with some tools to enroll eligible folks more efficiently.

Understanding that states will be facing the task of potentially enrolling large numbers of people on January 1, 2014, CMS is offering 5 targeted strategies that capitalize on already available information. These approaches to enrollment and renewal are designed to alleviate the administrative burdens on beneficiaries, the state, and the new systems – goals I hope we all can agree on.

1. Early adoption of MAGI. During the first months of open enrollment (October – December 2013), people applying for coverage that begins January 1^st will have their eligibility determined using the new MAGI-based methodologies. However, those applying for or renewing coverage effective in 2013 will need to be assessed using the existing rules. To avoid having to use two sets of rules during this time, states can choose to adopt the MAGI methodology as of October 1^st for all eligibility determinations.
2. Extending Renewal Periods. The ACA requires that individuals already enrolled in Medicaid cannot be found ineligible for coverage based solely on the conversion to the MAGI methodology prior to March 31, 2014, or their next renewal date (whichever is later). However, to ensure this important protection, states would need to use both the new MAGI rules and the existing rules to determine eligibility for those renewing coverage between January 1 and March 31, 2014. To avoid this duplication of effort, CMS will allow states to extend renewal dates beyond this three-month transition period.
3. Enrolling SNAP Participants in Medicaid. To qualify for SNAP, a household’s gross income (which is meticulously verified and is never more than 6-months old) cannot generally exceed 130% of the FPL. This temporary (available through the end of 2015) option allows states to streamline enrollment for SNAP participants whose eligibility for Medicaid will be based on MAGI methods. Estimates from CBPP suggest that 75-80% of SNAP households (that have at least one member under age 65 or not receiving SSI) are certain to contain members who are financially eligible for Medicaid.
4. Enrolling Parents of Medicaid/CHIP Kids. Based on our estimates, in 2010, 3.5 million uninsured parents who could gain Medicaid coverage under the ACA expansion already have a child who is enrolled in Medicaid or CHIP. CMS is offering to states (also on a temporary basis) an opportunity to expedite the enrollment of these parents by reactivating recent parent applications that have been denied or by reviewing children’s cases to identify potentially-eligible parents. States could also send these parents a pre-populated application – an approach that doesn’t require special permission.
5. 12-Month Continuous Eligibility for Adults. States have long had the option to provide 12-month continuous eligibility for children regardless of fluctuations in income. And almost two-thirds of states do, strengthening the continuity of care and promoting ongoing coverage. CMS is now allowing states to extend this effective retention strategy to adults.

Section 1115 waivers are required for many of these changes, but showing off their own efficiency goals, CMS promises to ensure a streamlined review and approval process for states looking to capitalize on these strategies. And regardless of whether or not your state has decided to extend Medicaid to more low-income adults, these strategies are available.

Aren’t you feeling sunnier about the prospects of getting all these eligible people covered? I know I am.