Enrollment Strategies

States can use express lane eligibility (ELE), a simplified way to determine and re-determine CHIP and Medicaid eligibility, using:

• Income
• Household size
• Other eligibility factors from another program designated as an express lane agency

Express lane programs may include:

• Supplemental Nutrition Assistance Program (SNAP)
• Temporary Assistance for Needy Families (TANF)
• Head Start
• National School Lunch Program
• Women, Infants, and Children (WIC)

ELE was extended through federal fiscal year (FY) 2027 under the HEALTHY KIDS and the ACCESS Acts. Learn more about this extension in the October 5. 2018 SHO letter (# 18-010).

Effective January 1, 2024, states are required to provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid and the Children’s Health Insurance Program (CHIP).  Section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023) amended titles 1902(e)(12) and 2107(e)(1) of the Social Security Act to add this requirement.  Previously, states had the option to provide children with 12 months of continuous coverage under CHIP and Medicaid.

SHO Letter & FAQs

CMS State Health Official Letter 23-004

FAQs on Non-Payment of Premiums: Continuous Eligibility September 2023 State Health Official Letter Follow Up

All-State Call recording & slides

CMS All-State Call Slides

CMS All-State Call Recording

States can use presumptive eligibility under CHIP or Medicaid by paying for the costs of CHIP coverage with Title XXI funds during a period of presumptive eligibility pending:

• The screening process
• A final eligibility determination