Presumptive eligibility (PE) is an important tool for states to enroll people with low incomes into temporary Medicaid coverage. As California continues to expand eligibility for Medi-Cal, its Medicaid program, there is growing interest in understanding options for enrolling all eligible people. This report presents findings from two related studies that examined PE and a type of PE called hospital presumptive eligibility (HPE), with the goal of understanding opportunities for enhancing the ability of these processes in California to serve as a pathway to ongoing coverage. The first study focused on HPE in Medi-Cal and assessed the processes that hospitals use to help their patients who receive HPE submit applications for ongoing coverage through Medi-Cal or the Covered California marketplace; this study also assessed what is helpful and challenging about providing this assistance. The second study focused on how other states have implemented HPE for adults and PE for children. This study assessed promising practices in using HPE and PE as an on-ramp to longer-term Medicaid coverage that might be feasible in California.
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