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How can Federal and State initiatives promote health IT for public insurance enrollment and retention?

At the Federal level, the recent reauthorization of CHIP (PDF - 424KB) provides States continued funding for the program as well as additional opportunities to expand enrollment, retention, and outreach through the use and implementation of health IT. Under section 213 of the CHIP legislation, the U.S. Department of Health and Human Services is directed to produce a model process of interstate coordinated enrollment and coverage. The process for the model development will include stakeholders such as State Medicaid directors and organizations representing the views of program beneficiaries. Another provision, section 211, in the law allows States to develop a system of electronic citizenship verification through the use of Social Security numbers. With enhanced matching funds for both construction and maintenance, States can build a system to verify applicant citizenship thereby enhancing enrollment and retention within Medicaid and CHIP.
 
States are also provided an Express Lane Option to enroll and retain children within public insurance programs as detailed in section 203 of the CHIP legislation. An "express lane option" allows States the flexibility to use a finding from another need-based program (as to income or another eligibility element) to determine eligibility and renewal. With this option, States can utilize relevant findings from school lunch programs, Women, Infant, and Children (WIC) programs, and food stamp programs when determining eligibility. Such legislative actions further enhance States' ability to use other databases to simplify enrollment procedures. 

State Governments play an important role with regard to the advancement of health IT. Leadership is required around privacy and security, health information exchange (HIE) and health IT adoption issues. In the legislative period between January 2007 and August 2008, more than 370 bills with wide-ranging health IT provisions were introduced to State legislative bodies. A report by the National Conference of State Legislatures (PDF - 1.7MB) details these efforts and notes that there are five major trends across these legislative initiatives:

• Planning - legislation creating study commissions and/or advisory committees that typically define membership and set tasks (e.g., developing a statewide roadmap for health IT)
• Targeted financing initiatives - legislation creating funding mechanisms for health IT initiatives.
• Privacy - legislation addressing provider and consumer concerns around privacy and security.
• Promotion of HIE - legislation establishing and sustaining HIE organizations and infrastructure and promoting interoperable health IT tools.
• Advancing health IT adoption and use - legislation mandating or incentivizing the use of health IT.

To aid in the identification of legislative barriers to the use of health IT within both the public and private sectors, Louisiana enacted SB 332 (PDF - 144KB) establishing the Health Care Information Technology and Infrastructure Collaborative. The collaborative will advise the secretary of the Department of Health and Hospitals and the State legislature on an annual basis on identified legal impediments.

Related Resources:

• Report: Congressional Budget Office Analysis of the Children's Health Insurance Program Reauthorization Act of 2009 (PDF - 44KB)
• Website: HIT Champions projects to transform Health Information Technology
• Brief: Modernizing Medicaid and SCHIP So They Work Better for Children and Taxpayers: The Case for Wise Investments in Health IT