Heathcare Express Lane Eligibility Act

Summary: The Healthcare Express Lane Eligibility Act will automatically enroll into the Medicaid and CHIP programs those recipients of SNAP benefits who are eligible for health coverage but not yet enrolled.

Based on MD SB 26 (2023)

Background: See Medicaid.gov


This Act shall be called the “Healthcare Express Lane Eligibility Act.”


(A) FINDINGS—The legislature finds that:

1) Tens of thousands of state residents are eligible for the Medicaid or CHIP programs but are not currently enrolled.

2) The state has information about SNAP (formerly known as food stamp) recipients which can be used to identify those who are eligible for Medicaid or CHIP.

3) The federal Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) began an Express Lane Eligibility (ELE) option, allowing states to use the eligibility findings from other public programs like SNAP to streamline enrollment or renewal for Medicaid and CHIP.

4) At least seven states currently use Express Lane Eligibility this way.

5) By using Express Lane Eligibility to automatically enroll residents into Medicaid or CHIP, the state improves healthcare for those in need, while simultaneously reducing the number of uninsured patients which, in turn, helps stabilize the healthcare finance system, especially for hospitals.

(B) PURPOSE—This law is enacted to protect the health and wellbeing of residents.


After section XXX, the following new section XXX shall be inserted:

(X) BEHAVIORAL HEALTH HOTLINE—On or before [July 1, 2025], subject to the limitations of the state budget and as permitted by federal law, the Department [of Health]:

1) Shall establish an Express Lane Eligibility Program to enroll individuals into the state Medical Assistance Program (Medicaid) and the state Children’s Health Insurance Program (CHIP) based on eligibility finding by the Supplemental Nutrition Assistance Program (SNAP);

2) May not consider any other income or eligibility requirements;

3) To the extent that a waiver is needed to maximize the number of state residents who may qualify for the Express Lane Eligibility Program, shall apply to the Centers for Medicare and Medicaid Services for one or more waivers under Section 1115 of the federal Social Security Act to implement the Express Lane Eligibility Program; and

4) Shall make all reasonable efforts to expedite enrollment of eligible individuals in the Express Lane Eligibility Program, provided that the Department may propose or implement the use of Express Lane Eligibility for renewals before proposing or implementing the use of Express Lane Eligibility for initial enrollment.


This law shall become effective on XXXX 1, 202X.