This report released by the State Health Access Reform Evaluation (SHARE) program provides lessons learned from the implementation of Maryland’s Kids First Act. Maryland is one of only three states using income and state tax data to improve insurance enrollment efforts.

From the report:

Either through state legislation or administration action, state income tax forms could go beyond asking parents to identify their uninsured children and give parents an opportunity to request disclosure of their tax data to the state’s health agency for purposes of a health insurance eligibility determination for their uninsured children. Indeed, CHIPRA expressly authorizes state agencies with data relevant to Medicaid and CHIP eligibility to share these data with state Medicaid and CHIP programs, so long as various procedural requirements are observed. These include an opportunity for parents to consent or opt‐out actively before the data are shared.xii Whether these steps are legally sufficient at the state level depends on state‐by‐state legal interpretation of state law. Maryland’s experience with the Kids First Act speaks to the importance of collaboration between state revenue and health agencies if either option is to be feasible. Even if parents are given the option to permit inter‐agency data sharing, the tax agency must modify the tax forms to include the appropriate language, which—as indicated by Maryland’s experience—may be done best with input from the state health agency.

Full report: Using Information from Income Tax Forms to Target Medicaid and CHIP Outreach (PDF | 551.06 KB)

State Health Access Data Assistance Center/ Robert Wood Johnson Foundation (2009). Using information from income tax forms to target Medicaid and CHIP outreach: preliminary results of the Maryland Kids First Act. Idala, D., Roddy, T., Milligan, C., Sommers, A., Willis, B., Clark, A., and Dorn, S.