CMS Announces New State Option to Streamline Medicaid Enrollment and Renewal

By Suzanne Wikle

On August 31, the Centers for Medicare and Medicaid Services (CMS) announced a new opportunity for states to use existing data to determine Medicaid eligibility. The new guidance provides states with an exciting new option to use income data from SNAP (or other means-tested programs) to determine Medicaid eligibility, both initially and upon renewal.  Adopting this strategy will reduce administrative burdens on states and recipients, allowing states to offer a streamlined application process to many individuals who are receiving SNAP but not Medicaid, both of which are important work support programs.

The new option provided in this guidance only applies to a subset of SNAP recipients who are certain to be income-eligible for Medicaid based on their gross SNAP income and household composition.  This new tool for states to increase Medicaid enrollment is especially exciting because it can be used for both enrollment and renewal, does not require a waiver, and is available on an ongoing basis. With the new guidance, CMS continues to provide states with tools to simplify Medicaid eligibility determinations, enrollment, and renewals.

This guidance expands upon an option originally provided to states in guidance issued in May 2013. In the six states that opted to use “strategy 3” from the 2013 guidance, which allows states to enroll most SNAP recipients under age 65 into Medicaid,  the use of SNAP data led to more than 700,000 Medicaid enrollments.  However, this strategy can only be used for initial enrollment, requires states to obtain a waiver, and was originally scheduled to expire in December 2015. In the new guidance CMS indicates it will continue to approve waivers beyond the original 2015 expiration date for “strategy 3” and other options provided in the 2013 guidance to the extent “necessary to ensure that states establish income and eligibility determination systems that protect beneficiaries” or in a state that has newly expanded Medicaid eligibility through the Affordable Care Act (ACA).

As states continue to tackle the job of implementing the ACA, using new options to streamline and simplify enrollment procedures across programs will be imperative to achieving efficiency and reducing burdens, both for caseworkers and those receiving the benefits.  This week’s guidance from CMS provides states with one more tool to streamline access to work support programs. With numerous additional states adopting Medicaid expansion since the 2013 guidance, this new option has great potential to build upon “strategy 3” and reach millions of uninsured Americans eligible for Medicaid.