Enrolling Childless Adults in Medicaid: Lessons from the New York Experience and Opportunities in Health Reform

This United Hospital Fund-Medicaid Institute issue brief, Enrolling Childless Adults in Medicaid: Lessons from the New York Experience and Opportunities in Health Reform, provides information about the key characteristics and coverage patterns of childless adults in New York, shares lessons from a recent study of uninsured childless adults who are eligible for Medicaid, and provides policy considerations for increasing this group’s participation in Medicaid.

While New York has been a leader in extending Medicaid eligibility to childless adults, its experience demonstrates that this is one of the hardest groups to enroll.

Despite the challenges it will entail, enrollment of childless adults will play a central role in health reform’s pursuit of near-universal coverage, while the Federal government funds almost all of the cost of the expansion. States can take advantage of new Federal options to do the following:

• streamline eligibility rules and procedures to ease enrollment for all eligible persons;
• develop policies to address the issue of fluctuating incomes during the year (such as pursuing an average annual income test) and procedures to ensure seamless transition to new coverage options in the insurance exchange; and
• target outreach and enrollment efforts specifically at childless adults, making it clear that they are eligible for public coverage; and more clearly explain immigrants’ eligibility for public coverage.

Read the brief.