Case Study of Massachusett's Express Lane Eligibility Processes

Case Study of Massachusett's Express Lane Eligibility Processes

CHIPRA Express Lane Eligibility Evaluation
Published: Nov 19, 2013
Publisher: Washington, DC: Mathematica Policy Research and Health Management Associates
Associated Project

Evaluating Express Lane Eligibility

Time frame: 2011-2014

Prepared for:

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation


Jennifer Edwards

Diana Rodin

In September 2012, Massachusetts implemented express lane eligibility (ELE) at renewal for families enrolled in MassHealth, the state’s Medicaid and CHIP programs, and the Supplemental Nutrition Assistance Program (SNAP). MassHealth uses income eligibility information from SNAP in lieu of requiring families to provide the information at renewal. Unlike ELE policies in other states that only assist children, Massachusetts’ ELE policy includes children and their parents; this was necessary because MassHealth’s eligibility system stores information for the family as a whole rather than for each individual, and also desirable for reducing the burden on families. Massachusetts had to obtain a Section 1115 waiver from the Centers for Medicare & Medicaid Services (CMS) to be able to include parents in the ELE renewal process. This report, part of a larger Congressionally-mandated evaluation of ELE, presents findings from a case study of Massachusetts’ ELE policy, conducted in April 2013.

Although Massachusetts has the highest rate of insurance coverage in the nation, the percentage of people losing MassHealth coverage for administrative reasons was high in comparison to the number losing coverage due to actual changes in eligibility. The ELE process the state adopted reduces the paperwork burden on families and keep eligible families enrolled, reducing churn while also reducing the administrative burden of processing renewals.

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