Most state Medicaid agencies contract with private companies to provide automated software for determining Medicaid eligibility. For more than a decade, these systems have been known to have flaws that result in thousands of people incorrectly losing Medicaid coverage. In Arizona, errors in the eligibility system caused immigrants to incorrectly lose coverage. In Colorado, state auditors have repeatedly documented widespread problems with the notices sent to enrollees that are generated by the Deloitte-run computer system, such as wrong dates or contradictory information. In Texas, approximately 100,000 people lost Medicaid coverage in three months due to eligibility system errors with the Deloitte software. With states now implementing work requirements and other new OBBBA restrictions, there will be more opportunities for machine errors with devastating human impacts and minimal accountability.
Despite the fact that these privately designed systems are used for public benefit determinations and paid for with taxpayer money, information about the contracts is not always easily accessible. This map compiles state Medicaid eligibility systems contracts obtained via online research and public records requests. Where links to publicly posted contracts are available they are included. These systems are very complex and often include multiple vendors, Medicaid eligibility rules and state procurement practices are not static, and the availability of procurement information (e.g., state contracts with vendors) is different in every state. As such, the information presented here may not capture all of the information about every state; the goal is to collect available information about the primary vendor(s) that manage an eligibility system in a centralized, easy-to-use location and to update it as new information comes in. Research and information collection is ongoing and this map will be updated as we continue to obtain information.
The National Health Law Program thanks our partners in the Benefits Tech Advocacy Hub, including Upturn and TechTonic Justice, for their critical collaboration in developing this project, obtaining contracts, and analyzing their contents.
If you have information about state Medicaid eligibility system contracts, please contact [email protected]. Members of the press who would like to speak with NHeLP and our partners can contact [email protected].
