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The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provided states with new policy tools to address shortfalls in enrollment and retention, one of which is Express Lane Eligibility (ELE). With ELE, a Medicaid and/or CHIP program can rely on another agency’s eligibility findings to qualify children for public health insurance coverage. This report presents cross-cutting findings from a Congressionally-mandated evaluation of ELE, conducted by the Urban Institute in partnership with Mathematica Policy Research, Inc. Findings relate to key design features and implementation experiences, including enrollment and retention, administrative costs and savings, utilization of services, and case studies of implementation.