Per ACA mandate, states modernize their Medicaid programs

States must complete all upgrades by January 2014

Topics: Medicaid, Reimbursement, Finance, Health Policy, Market Trends, Strategy, Payer and Regulatory Policy, Information Technology, Standards and Regulatory Policy

January 24, 2013

A new report from the Kaiser Family Foundation (KFF) finds that most states are taking steps to modernize their Medicaid enrollment systems—but some have not completed upgrades that the Affordable Care Act (ACA) requires by next year.

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Per the ACA, all state Medicaid programs must shift to Web-based enrollment systems by January 2014. The requirement applies to all states, even those that decide not to proceed with the ACA's Medicaid expansion.

According to The Hill's "Healthwatch," the requirement aims to ensure that Medicaid IT systems can exchange data with the online health insurance marketplaces mandated under the ACA. The Obama administration is covering 90% of the cost for any upgrades to state Medicaid IT systems until the end of 2015, when the federal matching share will drop to 50%.

The KFF survey found that:

  • 47 states have received or applied for federal funds to upgrade their Medicaid systems;
  • 45 states currently interact electronically with the Social Security Administration to verify citizenship;
  • 42 states have started developing their Medicaid IT upgrades;
  • 37 states offer an online application for Medicaid or the Children's Health Insurance Program (CHIP); and
  • 28 states allow beneficiaries to renew their Medicaid or CHIP enrollment online.

Diane Rowland—executive director of the Kaiser Commission on Medicaid and the Uninsuredin a statement said, "Our survey shows that states already are making significant advances to modernize the Medicaid enrollment process in 2014 to lower barriers to coverage and reduce administrative burdens for both families and states" (Viebeck, "Healthwatch," The Hill, 1/23; Kliff, "Wonkblog," Washington Post, 1/23; Galewitz, "Capsules," Kaiser Health News, 1/23; Daly, Modern Healthcare, 1/23 [subscription required]).

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