Survey: All States, D.C. Have Online Medicaid or CHIP Applications

January 29, 2015 in News

While states have made progress digitizing their eligibility determination processes for Medicaid and the Children’s Health Insurance Program, many states still face challenges verifying users’ data and re-enrolling beneficiaries, according to a survey from the Kaiser Family Foundation, Modern Healthcare reports (Dickson, Modern Healthcare, 1/20).

Survey Details

Kaiser Family Foundation’s 13th annual 50-state survey sought to examine state Medicaid and CHIP programs “one year into the post-Affordable Care Act era.” Specifically, the survey assessed states’ Medicaid and CHIP programs by examining:

  • Cost-sharing policies;
  • Eligibility;
  • Enrollment; and
  • Renewal (KFF report, 1/20).

Survey Findings

The survey found that 49 states and Washington, D.C., have implemented online applications for Medicaid, CHIP or both as of Jan. 1, up from 37 states that had online applications in January 2013. According to the survey, Tennessee is the only state that does not have online applications and instead relies on to determine applicants’ eligibility for the programs (Modern Healthcare, 1/20).

Further, the survey found that:

  • 47 states now accept telephone applications; and
  • 36 states offer consumers an online account to manage their Medicaid coverage.

In addition, the survey found that:

  • All 50 states and Washington D.C. have implemented eligibility verification practices that rely on electronic data and reduce paperwork;
  • Many states are working to streamline reenrollment processes by automating and digitizing coverage renewal; and
  • 12 states have established a single, integrated system that determined Medicaid and exchange eligibility, while the remaining states have two separate systems (KFF report, 1/20).

Ongoing Challenges

During a Kaiser webinar on Jan. 20, state officials said they are pleased with their progress. However, Rex Plouck, portfolio manager for the Ohio Office of Health Transformation, also listed several ongoing challenges that require states to process certain applications manually, including:

  • Authenticating applicants, particularly if an applicant has a common name that could lead to confusion over records; and
  • Inaccurate applicant information, including income data that do not align with IRS information.

In addition, states also are having difficulty re-enrolling disabled adults and children who were enrolled in Medicaid before certain provisions of the ACA took effect. Those provisions expanded Medicaid eligibility and established a new formula for determining household income.

The survey concluded that the ongoing technology issues likely mean that states will continue relying on pools of federal funds to help them shoulder IT-related costs for Medicaid (Modern Healthcare, 1/20).

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