With Express Lane Eligibility (ELE), a state’s Medicaid and CHIP programs can rely on another agency’s eligibility findings to qualify children for health coverage. This report examines Iowa’s two separate ELE processes. The first process—an automatic referral system from Medicaid to CHIP—has significantly increased enrollment in CHIP. The second process, however, which links eligibility for the Supplemental Nutrition Assistance Program (SNAP) to Medicaid, has resulted in fewer enrollment gains likely because it requires families to submit additional paperwork for enrollment.