State Medicaid and CHIP Eligibility Verification Plans

Due to the ACA’s new eligibility verification rules, states have developed plans outlining Medicaid and CHIP eligibility verification procedures. This chart highlights key elements from states’ verification plans, such as which eligibility factors are verified through electronic data and the specific data sources states are using, as well as whether self-attestation is accepted for some eligibility factors. The chart also contains information about how states will determine reasonable compatibility, which is how they will resolve issues if there are discrepancies between electronic data sources and information provided by applicants.

Certain eligibility factors are not included in the chart, such as pregnancy,1 Social Security Numbers,2 citizenship and immigration status3 because the ACA requires states to use the same verification processes for these factors. State CHIP programs also have unique eligibility factors that must be verified in addition to those listed below. Click here for a chart on CHIP-specific eligibility verification plans.

This chart is based on information contained in publicly available state Medicaid/CHIP eligibility verification plans; each state abbreviation links to each state’s plan. Please note that not all state verification plans have been approved and information from them will be added to this chart as they become available.

Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content. Do you know of information that should be added to this chart? Your feedback is central to our ongoing, real-time process, so tell us in a comment below.