Interim Report Sounds Alarm on Rushed Implementation of Draconian Enrollment and Eligibility Policies; While Taxpayers Fund a Windfall for For-Profit Consulting Firms, Millions Stand to Lose Coverage Amid Error-Prone Systems
Washington, D.C. – Senate Finance Committee Ranking Member Ron Wyden, D-Ore., and Senators Elizabeth Warren, D-Mass., and Raphael Warnock, D-Ga., today released an interim report exposing how for-profit technology firms that frequently contract with state Medicaid programs stand to receive a massive taxpayer-funded windfall while implementing Republican health care cuts that will cause millions of American families to lose their health insurance.
“These organizations have a grave responsibility to ensure millions are able to get the health care they deserve, and they are failing to meet that responsibility,” Ranking Member Wyden said. “The nation is just weeks away from Republicans rolling out the red tape on unsuspecting Americans who have life-or-death health care needs. This rushed roll out is going to be a disaster. It is essential to hold these contractors to a higher standard and implement commonsense accountability measures that make fast, simple and durable enrollment in health care coverage the bar for earning taxpayer dollars.”
“As President Trump and Republicans gut health care for millions of Americans, big corporations are cashing in by running systems that snarl Americans in red tape and strip them of their Medicaid coverage. It’s plain wrong for these companies to boost their profits by kicking people off their health care, and I’ll keep fighting to end this corporate greed,” said Senator Warren.
“No one should have to worry about losing their health care coverage because of red tape and bureaucracy,” said Senator Reverend Raphael Warnock. “Our report makes clear that errors and delays in state Medicaid eligibility systems are putting health care coverage at risk for vulnerable Americans while wasting taxpayer dollars. As states prepare to implement new Medicaid work reporting requirements imposed by Congressional Republicans, these existing problems threaten to create even more barriers for working Americans who depend on this coverage. Our focus must be on making sure that eligible Americans do not lose access to coverage because of failures beyond their control.”
The investigation probed five of the largest companies that build, operate, or support Medicaid eligibility and enrollment systems for states: Maximus, Gainwell, General Dynamics Information Technology, Conduent, and Deloitte. The report found that these contractors have a track record of errors that wrongfully strip health coverage from eligible Americans. Now, they are preparing to implement the complex and bureaucratic work reporting requirements and other harmful policies created by Republicans in the Big Ugly Bill, which will result in millions of Americans losing their health coverage.
The report presents a disturbing pattern of non-responsiveness from each company. None of the companies provided historical data on the number of individuals their systems referred to state Medicaid offices as ineligible for coverage, and none provided meaningful detail on how they test their systems for accuracy. Furthermore, no vendor provided their contracts to the committee to demonstrate whether they contain adequate incentives for error-free administrative support. This non-responsiveness, in addition to the documented history of poor performance, compounds fears that the Republican health care cuts will be disastrous for Americans who count on Medicaid for affordable health care.
Senate Democrats remain committed to repealing Republicans’ red tape requirements. To further protect patients and hold contractors accountable, the senators outlined a series of preliminary recommendations for the Centers for Medicare and Medicaid Services, such as:
- Creating mandatory contract terms to create accountability for contractor errors, including standardized financial penalties for wrongful disenrollments.
- Directing the agency to publicly identify all vendors under contract and make all vendor contracts, amendments, and performance data publicly available.
- Mandating independent audits for all vendors receiving federal administrative matching funds.
- Prohibiting contractors from simultaneously holding Medicaid eligibility determination contracts and appeals or fair hearing contracts for the same state.
The senators have led the effort to spotlight the dangers of Republican health care cuts and the potential that for-profit corporations will take advantage at taxpayers’ expense. The senators launched this investigation last year. This investigation comes as Americans begin to feel the impact of the disastrous Republican health care cuts, with millions projected to lose their insurance due to the draconian policies and rushed implementation timelines pushed by Trump and congressional Republicans.
The text of the report is here.
A web version of this release is here.
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