The Patient Protection and Affordable Care Act (also known as the Affordable Care Act) envisions a simple and streamlined enrollment process for Medicaid, the Children's Health Insurance Program (CHIP), Basic Health, and the premium credits that will help consumers purchase coverage through the exchanges. The Affordable Care Act allows -- and in many cases requires -- that states take steps to dramatically ease the enrollment process for consumers. Automated eligibility and enrollment systems will be an important part of that process, but there are other tools states can use. One that has not received much attention in the context of health reform implementation is presumptive eligibility. Presumptive eligibility is not a new idea; states have used it to some extent in the Medicaid program since the mid-1980s and in CHIP since its enactment in the late1990s. However, the Affordable Care Act significantly expands states' ability to use presumptive eligibility to streamline the enrollment process for Medicaid and CHIP. This issue brief provides an overview of presumptive eligibility, explores the changes in the new law that pertain to presumptive eligibility, and outlines how presumptive eligibility fits into the new enrollment paradigm.

Many uninsured children have unmet health care needs. However, when they apply for health coverage through Medicaid and CHIP, they often have to wait for over a month before their application is processed and their parents can make doctors' appointments. "Presumptive eligibility" can help children get needed care right away.

Presumptive Eligibility (PE) is a Medicaid and Child Health Plan Plus (CHP+) program that provides immediate temporary medical coverage for children under 19 and pregnant women. You must complete an application and appear eligible to get the temporary health care benefits.