Basic Considerations

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-3 includes many provisions designed to give states some tools which may be used to effectively enroll eligible children in Medical Assistance. Section 203 of CHIPRA allows states to rely on the findings from an entity designated by the state as an “Express Lane agency” to determine whether a child satisfies one or more factors of eligibility for Medical Assistance. Such agencies are identified by the state Medicaid agency as being capable of making a finding regarding one or more programmatic eligibility requirements using information the agencies are already collecting. “Express Lane agencies” are public agencies which would include the following:

Agencies that determine eligibility for assistance for any of the following programs or under any of the following authorities: The Temporary Assistance for Needy Families (TANF) program funded under part A of title IV of the Social Security Act A State program funded under title IV-D of the Act (Child Support Enforcement) The State Medicaid or PCK program The Supplemental Nutrition Assistance Program (SNAP) (formerly Food Stamps) The Richard B. Russell National School Lunch Act (School Lunch programs) The Child Nutrition Act of 1966 (the Special Supplemental Nutrition Program for Women, Infants, and Children, or “WIC”) The United States Housing Act of 1937 Head Start Child Care under the Child Care and Development Block Grant Act of 1990 Homeless Assistance under the Stewart B. McKinney Homeless Assistance Act The Native American Housing Assistance and Self-Determination Act of 1996

Another State-specified governmental agency that has fiscal liability or legal responsibility for the accuracy of the eligibility determination findings relied on by the State.

A public agency that is subject to an interagency agreement limiting the disclosure and use of your information disclosed for purposes of determining eligibility for Medical Assistance .

The State Medical Assistance agency remains responsible for making the ultimate determination of eligibility. The Medical Assistance programs may apply the ELE option to children up to age 19.