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 the ELE program in Maryland, one of only a handful of states that use the state income tax system to reach eligible but unenrolled children. Despite the innovative approach, increases in Medicaid enrollment have been lower than expected, likely due to the requirement for recipients to “opt-in” to data sharing and their hesitancy to share data with the government. Stakeholders are hopeful, however, that enrollment will increase as taxpayers become more familiar with the data-sharing question on the tax form.
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