Case Study of South Carolina's Express Lane Eligibility

Case Study of South Carolina's Express Lane Eligibility

CHIPRA Express Lane Eligibility Evaluation
Published: Nov 22, 2013
Publisher: Washington, DC: Mathematica Policy Research, Health Management Associates, and Urban Institute
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

Rebecca Kellenberg

South Carolina implemented Express Lane Eligibility (ELE) to simplify children’s Medicaid renewals in April 2011, followed by ELE for Medicaid enrollment in September 2012. In South Carolina, Medicaid includes the Title XIX program as well as the Title XXI Medicaid expansion and is administered by the Department of Health and Human Services (DHHS). For both ELE enrollment and renewal, the Medicaid program receives information from the Department of Social Services (DSS) about children’s eligibility for Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance to Needy Families (TANF) in lieu of families providing documentation of Medicaid eligibility. DHHS enrolls or renews the child’s coverage based on this information without requiring consent or other action on the part of the family, a policy which likely contributes to high rates of ELE participation. This report, part of a larger evaluation of ELE mandated by Congress, presents findings from a case study of South Carolina’s ELE policies, conducted in June 2013. South Carolina’s ELE initiatives have resulted in large enrollment and retention improvements. As of June 2013, more than 92,000 children have enrolled in Medicaid through ELE, and over 276,000 children’s Medicaid benefits have been renewed through ELE.

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