Supplemental Nutrition Assistance Program (SNAP)
The Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, is a federal anti-hunger program that provides benefits to low-income households for purchasing food. In 2011, SNAP served nearly 45 million low-income individuals, almost 75% of whom are families with children. CLASP provides policy analysis and conducts advocacy efforts to expand access of SNAP programs and services for low-income families.
Oct 29, 2015 | PERMALINK »
Targeted Medicaid Enrollment Reaches More Children
The rate of children without health insurance has hit an all-time low of 6 percent, according to a new report from the Center for Children and Families. The drop is largely attributable to the Affordable Care Act (ACA) and to states’ efforts to increase enrollment. States that have opted to expand Medicaid to low-income adults saw the largest improvement in children’s coverage, even though most uninsured children were already eligible for health insurance under Medicaid or the Children's Health Insurance Program (CHIP) prior to ACA. The report uses American Community Survey data from 2014, the first full year of ACA implementation.
All Medicaid expansion states saw a decline in uninsured children, with an average decrease nearly twice that of non-expansion states. Much of the increase in children’s enrollment, especially in Medicaid expansion states, is likely due to enrollment of children who were already eligible. This is often referred to as the “welcome mat” effect. Multiple factors drive this effect, including increased awareness of Medicaid and automatic enrollment of children when their parents apply. Rhode Island and Colorado, two of the states with the greatest declines, were participants in the Work Support Strategies initiative, a targeted effort to coordinate programs to maximize enrollment of eligible children and adults.
In addition to the welcome mat effect, states can explore using three targeted enrollment options. As outlined in May 2013 guidance and extended as part of the August 2015 guidance, states can request a waiver to use Supplemental Nutrition Assistance Program (SNAP) data to identify those who are likely eligible for Medicaid. States may also use the waiver to identify newly eligible parents of children enrolled in Medicaid. Six states (AR, CA, IL, NJ, OR, WV) have used these strategies to enroll a total of 726,584 people.
A newer option provided to states in August 2015 allows the use of SNAP data to identify a smaller group of people who are certainly eligible for Medicaid. States must submit a State Plan Amendment to employ this strategy, which can be used on an ongoing basis for Medicaid enrollments and renewal s.
States that have not expanded Medicaid for adults can still use a version of targeted enrollment known as “Express Lane Eligibility,” which automatically determines children eligible for health insurance based on SNAP receipt.
West Virginia’s data demonstrates the impact of targeted enrollment strategies.
In 2013, prior to ACA implementation, West Virginia had a relatively low rate of uninsured children at 5.3 percent. This makes their post-ACA rate (3 percent in 2014) all the more remarkable. As the rate of uninsured children declines, it’s typically more difficult to identify those who are eligible yet uninsured, and broad public awareness or outreach strategies become less effective.
West Virginia coupled its Medicaid expansion with the state waiver targeted enrollment option. The state used SNAP data to identify people likely eligible for Medicaid, as well as targeted parents of children already enrolled in Medicaid.
Because income eligibility limits are similar for Medicaid and SNAP, the SNAP strategy employed by West Virginia is an effective way for states to identify who is likely to be eligible for Medicaid, conduct outreach to those individuals, and receive their consent for enrollment. This strategy may be especially effective at identifying children who are not enrolled in Medicaid despite traditionally being eligible. Using SNAP and other targeted strategies, West Virginia successfully enrolled 70,574 people in Medicaid. Among all states, West Virginia saw the largest percent decline in the number of uninsured children from 2013 to 2014 (43.7 percent).
More states should follow the lead of West Virginia and use existing data to identify those who are likely eligible for Medicaid but not enrolled in the program.
- Helly Lee and Elizabeth Lower-Basch | Apr 16, 2015 Q & A: Meeting ABAWD Activity Requirements through Training Activities
- Randi Hall and Helly Lee | Mar 20, 2015 FNS Announces SNAP E&T Pilots in 10 States
- Elizabeth Lower-Basch | Mar 10, 2014 SNAP E&T Overview
- Helly Lee | Feb 11, 2014 Congress Enacts Farm Bill After Years of Debate and Negotiations
- Elizabeth Lower-Basch and Lavanya Mohan | Nov 21, 2012 Access to Food Stamps in Early Childhood Leads to Better Adult Health and Economic Outcomes
- Liz Ben-Ishai | Sep 16, 2015 Volatile Job Schedules and Access to Public Benefits
- Apr 16, 2015 Q & A: Meeting ABAWD Activity Requirements through Training Activities
- CLASP | Sep 16, 2014 New Census Data Tell Us That Poverty Fell in 2013
- Elizabeth Lower-Basch and Helly Lee | Sep 02, 2014 SNAP E&T Pilots
- Lavanya Mohan and Helly Lee | Jul 30, 2014 Minnesota’s Pay-for-Performance SNAP Employment and Training Pilot Program