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 Louisiana's experience with ELE, finding that Louisiana increased children's coverage and saved significant administrative costs. The first state to implement ELE's auto-enrollment option, Louisiana found that almost the same percentage of children obtained care, whether they enrolled (1) via standard Medicaid methods or (2) via ELE, with parents who consented to enrollment by accessing services. When the state changed procedures and required parents to consent by checking a box, enrollment declined by 62%.