Louisiana Sets New Bar for State Efficiency

In an important development for low-income people, Louisiana announced it will be the first state in the country to seek approval from the U.S. Centers for Medicare and Medicaid Services (CMS) to use data already on file to streamline its process for making determinations on eligibility for Medicaid. Thanks to an option provided to states in August 2015, Louisiana plans to use information that the state’s Supplemental Nutrition Assistance Program (SNAP) agency already has to assist with Medicaid enrollment in launching its Medicaid expansion this summer. This major development out of Louisiana reflects strong leadership and a vision for improving the efficiency of government programs. Louisiana is taking this step in part because of the bold move made by newly inaugurated Governor John Bel Edwards who, in his first executive action after taking office in January 2016, expanded Medicaid under provisions available to states through the Affordable Care Act (ACA).

Many people who are eligible for Medicaid under the ACA Medicaid expansion are also eligible for SNAP. Therefore, it simply makes sense to use data from one program to aid enrollment in the other, rather than requiring people to provide duplicative information about their income. Under the option Louisiana is seeking approval to use, states may utilize income information on record for select SNAP populations to determine Medicaid eligibility.

This letter from CMS to states outlines all the criteria for this option. Generally this method of streamlined enrollment is helpful in determining Medicaid eligibility for people under 65 years old with stable income and household characteristics who are certain to be eligible for Medicaid. For example, a single mother of two children who earns minimum wage and has no other income would benefit from Louisiana’s method by having her SNAP income information used to determine her Medicaid eligibility – reducing the burden of paperwork on the parent and eliminating unnecessary processing by the state. Simply put, it’s common sense to eliminate the need to prove what the state already knows, and doing so makes the work of state government more efficient.

What’s particularly exciting is that Louisiana is availing itself of an option to use SNAP information for initial enrollment and renewal. Evidence shows that many eligible people lose Medicaid coverage at the time of their renewal, often due to missing paperwork. However, because most people reapply after losing coverage, this “churning” of eligible people is costly to the state and disruptive to enrollees and medical providers. Louisiana’s approach promises to reduce the rate of churn, which in turn increases efficiency and saves the state money by processing fewer applications.

Such streamlining and efficiency is how programs should operate in 2016, and more states should follow Louisiana’s lead. Louisiana is raising the bar and setting new standards for how government can operate at the top if its game – efficiency for the state and for the people who are working hard but struggle to make ends meet. Other states should take note and examine whether they are fully utilizing information on hand in one agency to eliminate duplicative work elsewhere.