New opportunity to streamline Medicaid enrollment through data sharing in 2014

Opportunity: CMS recently offered states an innovative and efficient way to streamline Medicaid enrollment for households already connected to state human service programs.[1] Specifically, through December 2015, CMS will allow states to enroll SNAP recipients (as well as parents of children receiving Medicaid) without requiring the submission or processing of a new Medicaid application. This streamlined enrollment process has opportunity to:

• Quickly increase access to health coverage for vulnerable households. Research shows that 75-80% of non-elderly, non-disabled SNAP recipients will be eligible for MAGI-based Medicaid and all necessary verification already resides in their SNAP case file.[2]
• Significantly reduce the administrative burden on local Medicaid offices. An estimated 25-40% of those newly eligible for Medicaid in 2014 already receive SNAP benefits.[3] By enrolling these households through a streamlined process, the state can effectively remove these households from the “front door” of application processing at a time when demand for services is expected to sharply rise.

Options for Implementation: CMS proposed several options for states interested in pursuing this streamlined enrollment strategy:

1. Update SNAP application and renewal forms with a check-box that allows households to opt-in to Medicaid enrollment.
2. Send Medicaid cards to eligible households along with the notice of SNAP enrollment or recertification and provide a mechanism (via phone or online) for the household to opt-in to enrollment and “activate” the Medicaid card.
3. Propose another mechanism to CMS that allows states to capture household consent, such as targeted outreach.

How BDT Can Help: The implementation strategies proposed by CMS represent effective ways to incrementally enroll SNAP households into Medicaid over time, following existing application and recertification cycles. However, these strategies do not reduce the pent-up demand that is expected to overwhelm local Medicaid offices in the first year of ACA implementation.

To minimize the number of SNAP enrollees who are applying through Medicaid’s “front door” in 2014, a state can propose to accelerate the enrollment process for these households by conducting targeted outreach. Benefits Data Trust (BDT) seeks to support states in conducting outreach via mail and phone to SNAP recipients who are eligible for Medicaid to make them aware of this streamlined enrollment opportunity and capture their enrollment consent telephonically. This outreach could be pursued separately from, or in combination with, the incremental enrollment strategies described above to maximize the number of SNAP households taking advantage of this streamlined enrollment process.

Next steps

CMS has indicated that efficiently enrolling eligible individuals is a top priority and has ensured a streamlined review and approval process for states interested in implementing this approach. To further demonstrate this commitment, they have aligned the demonstration with the availability of enhanced federal match funds for states to build out their eligibility systems (at a 90% rate for development and a 75% rate for operations). This opportunity will be in effect through December 2015.

As implementation of the Affordable Care Act inches closer to October 1, states are being given an unprecedented opportunity to utilize a data driven approach to both increase access and create efficiencies to support local Medicaid offices. BDT welcomes to the chance to partner with states during this exciting time.

[1] See letter to State Health Officials re: Facilitating Medicaid and CHIP Enrollment and Renewal in 2014, May 17, 2013. Accessed at http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/SHO-13-003.pdf

[2] See “A Technical Assessment of SNAP and Medicaid Financial Eligibility under the Affordable Care Act.” Revised April 25, 2013. Accessed at http://www.cbpp.org/files/3-21-13health.pdf

[3] See “Coordinating Human Services Programs with Health Reform Implementation: A Toolkit for State Agencies,” December 2012. Accessed at http://www.cbpp.org/files/6-6-12health.pdf