Advocates, stakeholders, federal and state governments are busy planning strategies for enrolling millions of newly eligible people into health coverage in 2014. But last week, CMS quietly released guidance that could lighten the load on everyone.

The May 17 guidance lays out five state policy options. If elected, these options will increase the number of new eligibles who enroll in coverage on day one and remain covered throughout the year, while also easing the administrative burden of processing these applications.

The guidance allows states to enroll adults who we already know are eligible based on:

  • Supplemental Nutrition Assistance Program (SNAP) eligibility. Most households who qualify for SNAP have incomes that will also qualify them for Medicaid . The recent guidance empowers states to take advantage of their SNAP data by enrolling adults on that program straight into Medicaid, without requiring a new application. This option expires at the end of 2015.
  • Children’s income eligibility. States have a rich database of hundreds of thousands of potentially-eligible parents—those whose children are currently enrolled in Medicaid or CHIP. The guidance would allow states to enroll parents who are deemed eligible based on their children’s income eligibility, without requiring a new application. This option is also time-limited.

For both of these options, the process is not quite as seamless as enrolling the identified adults straight into coverage. States still need a signature (which can be written, electronic, oral or telephone-based) from the eligible adults and to verify some non-income eligibility criteria such as citizenship status. The guidance lays out several options for states to get this missing information as simply and expediently as possible.

The guidance also allows states to guarantee adults 12 months of coverage regardless of income fluctuations. Low-income households often experience small fluctuations in income that put them just above and below the Medicaid-eligibility level. To help states reduce the churn and administrative costs associated with these income changes, the guidance allows them to offer 12-month continuous eligibility to adults. 32 states already offer continuous eligibility to children in Medicaid or CHIP, but this is the first time that option has been available to adults.

Finally, the guidance includes two policy options aimed at easing the administrative burden on states from adopting a new income-counting methodology (Modified Adjusted Gross Income, or MAGI.)

The key to all these options is that they are just that: options. States must submit waivers to take advantage of them. Our work over the next few months is to encourage states to adopt these common-sense strategies for connecting families to the coverage they need.