Methods to Expand Medicaid Enrollment

States can expand the pool of women insured by Medicaid by streamlining the enrollment process.  Even if eligible, many people do not enroll, either because they do not know they are eligible or because they encounter barriers to enrollment even if their income meets the eligibility level.  Therefore, it is important for states to simplify enrollment procedures.  The Report Card focuses on three methods states can use to expand enrollment for certain populations.  First, states can adopt a policy that makes a pregnant woman “presumptively” eligible for Medicaid once she submits preliminary income information.¹  Second, states can simplify enrollment for families by allowing parents to apply jointly with their children using a simplified mail-in application.  Third, states can cover more people by eliminating the “asset test.”²  The asset test counts parents’ ownership of certain assets when determining the family’s eligibility for Medicaid.  Eliminating this test serves multiple purposes, including easing the application process, streamlining and reducing administrative costs and increasing the pool of eligible people. 

¹ 42 U.S.C. § 1396r-1(states may provide for making ambulatory prenatal care available to a pregnant woman during a presumptive eligibility period).

² Assets (or resources) refer to items of personal or real property.  State Medicaid programs determine resource standards that are then measured against the individual’s assets.  If these assets are less than the standard, the individual meets the asset test.  Assets that are countable are generally not homes, furniture or clothes.  Savings accounts can be counted, although the entire value of the account is not always included.  Cars can be counted, although this differs across states (i.e., some states do not count cars at all, some count only a second car, and others disregard a car up to a certain value).  Generally, asset limits are very low, ranging from $1,000 to $6,000 dollars. 42 U.S.C. § 1396u-1(b)(2)(c).