Most states are taking advantage of limited-time federal funding to upgrade their IT infrastructure in advance of new federal requirements for web-based Medicaid enrollment coming in 2014, according to a survey published this week by the Kaiser Family Foundation.
The federal requirements apply to all states, regardless of whether they plan to expand their Medicaid programs. In 2014, the systems must offer verification processes intended to deliver real-time eligibility determinations and coordinate with the mandated health insurance exchanges.
Through the end of 2015, the Obama administration will cover 90 percent of the state upgrades to allow them to share data with the online marketplaces mandated through the health reform law. Afterward, that drops to 50 percent.
The survey found that:
- 47 states have received or applied for federal funds to upgrade their Medicaid systems.
- 45 states 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.
- 28 states allow beneficiaries to renew their Medicaid or CHIP enrollment online.
- 30 states have a document imaging system statewide in either Medicaid or CHIP, while 22 states have it in both programs.
A Washington Post article highlights the federally-funded IT overhaul in Oklahoma, which has fought the health reform law every step of the way. That Medicaid system now allows patients to submit scanned documents online, and increased interoperability with the state's WIC (Women, Infants and Children) program means local offices don't have to ask applicants for the same information twice. A paper published this month in Health Affairs said Oklahoma's efforts could be an inspiration to other states--at least in some respects.
At last count, 22 governors support Medicaid expansion, including Arizona Gov. Jan Brewer, who is among the Republican state leaders who have softened their stance, while 15 governors remain undecided, Reuters reported recently. Many states, however, require legislative action, meaning the governor's stance won't necessarily make it happen. Texas, which like Oklahoma has been totally opposed to the health reform law, has been avoiding the question of Medicaid expansion, but looking at other ways to cut costs on delivering healthcare.