Express Lane Eligibility: Health Insurance Enrollment Through WIC

1
Express Lane Eligibility Health Insurance
Enrollment Through WIC

• Dawn Horner
• The Childrens Partnership
• April 8, 2001

2
The Need for Health Coverage

• 6.7 million uninsured children are eligible for
  Medicaid or the newly enacted State Childrens
  Health Insurance Program (SCHIP).
• Children with health insurance are more likely
  than their uninsured counterparts to receive
  consistent medical care and to have less
  long-term health problems.

3
Why WIC Is An Important Health Insurance Avenue

• 24 (1.5 million) of all low-income uninsured
  children are in families enrolled in WIC.
• WIC and Medicaid/SCHIP have similar income
  eligibility guidelines.
• 37 states have income eligibility guidelines for
  their health insurance programs at or above 185
  of the FPL.

4
Provide Health Outreach Materials Referrals

• At WIC intake.
• Referral to community groups or welfare office
  for application assistance.
• Call state or local health agency for information
  on health programs or
• Go to CDF web site for health flyers
  www.childrensdefense.org/signup

5
Create a Screening Tool to Identify Uninsured
Clients

• Expand Medicaid question to ask about all
  insurance, including private and SCHIP.
• Create lists to target uninsured clients for
  follow-up.
• Have uninsured clients authorize the sharing of
  contact information to Medicaid/SCHIP or
  community groups for follow-up.

6
Incorporate Health Curricula into Nutrition
Classes

• Class content can include
• Prenatal and child health care
• Medicaid/SCHIP rights responsibilities
• Public charge/immigration issues and
• ID of the best way to enroll in health insurance.
• A video could also be available to play in
  reception area.

7
Provide Enrollment Assistance On-Site

• Place Medicaid/SCHIP eligibility workers on-site.
  (state/locally funded)
• Local community groups can also provide staff to
  assist parents.
• Workers can rotate among sites.

8
Undertake Your Own Enrollment Activities

• Use outside funding to pay for non-WIC
  activities
• Enrollment Assistors.
• Liaisons to make initial contacts, arrange
  logistics for Eligibility Workers, and conduct
  tracking and follow-up.
• Funding can include foundations, state outreach
  funds, 1931(b) funding.

9
Adopt Presumptive Eligibility

• WIC programs can make Medicaid/SCHIP presumptive
  eligibility determinations for pregnant women and
  children.
• Families obtain coverage immediately have set
  amount of time to complete full application.
• Process most effective in WIC sites connected to
  clinics. (Nebraska)

10
Express Lane into Health Coverage

• Most children enrolled in WIC are income-
  eligible for Medicaid/SCHIP.
• Create linkages that can streamline health
  insurance enrollment process
• Joint WIC/Health application. (Vermont)
• Family consent to share income information with
  Medicaid/SCHIP to expedite enrollment.

11
Issues to Consider

• Extra staff time involved.
• Additional administrative costs.
• Establishing good relationship with state health
  agency.
• Different eligibility requirements, particularly
  immigration.
• Not diluting trust with families.

12
For Additional Information

• The Childrens Partnership Web site at
• www.childrenspartnership.org
• Express Lane Eligibility
• ResourcesWIC A Door to Health Care for
  Californias Children (conducted in collaboration
  with the California WIC Association)