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Medicaid Has Modernized the Enrollment Process

Not very long ago, applying for Medicaid could be a complex, time-intensive, and paper-dependent process. It could require an in-person interview at a government office, a major stumbling block for working people who were unable to take time away from their jobs to apply. Even as more states allowed applications to be mailed in and eliminated face-to-face interviews, many applicants still had to gather and present paystubs and other documents to substantiate the statements on their application. Waiting for an eligibility decision could delay needed care. A national survey of parents with children eligible for Medicaid or CHIP found that concerns about the application process constituted a top barrier to enrollment, with more than half of parents saying they thought enrolling their child would be somewhat or very difficult. 

Now times have changed, and so has the way many people apply for Medicaid. As a result of the Affordable Care Act, the process has been dramatically simplified and streamlined. Individuals may apply online, by telephone or by mail, as well as in person, and they can get help from application assistors in their communities or by calling a toll-free number. Requests for paper documents are a last resort, rather than a first step, for most people. States now rely on available electronic data sources to confirm information on the application, facilitating faster eligibility decisions so that eligible people can get their health care needs addressed quickly.

States are making substantial progress processing Medicaid and CHIP applications more efficiently, often in real or near real-time. For example, in Washington, 92 percent of applications are processed in under 24 hours; in New York, 80 percent of applications are processed in one session; and in Rhode Island, 66 percent of applications are processed without manual intervention or the requirement of additional information.

CMS is offering links/charts for informational purposes only, facts should not be construed as an endorsement of the organization's programs or activities

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