The federal government under the auspices of the Affordable Care Act spent big money getting state Medicaid programs wired to do more digital member enrollment—$10 billion, according to Medicaid.gov.
And thus far the money seems to be well spent, says a new analysis of 50 state Medicaid programs by the Kaiser Family Foundation.
Before the ACA, individuals could not apply for Medicaid by phone or online in many states. They typically had to provide paper documentation like pay stubs and wait weeks for an eligibility determination—and do it all over again at renewal, Kaiser says. Today, 50 states now take online applications for Medicaid (up from 36 in 2013). 49 states now allow phone applications (up from 17 from five years ago) and 46 have automated Medicaid renewal (up from 22 in 2013), Kaiser says.
Individuals in most states now can receive a real-time eligibility determination in less than 24 hours without having to submit pay stubs when the state is able to verify information through electronic data matches with trusted data sources, Kaiser says. “Under the Affordable Care Act, Medicaid expansion and non-expansion states alike have implemented streamlined Medicaid enrollment systems that facilitate real-time eligibility determinations and automated renewals,” Kaiser says.
With federal money to spend, state Medicaid agencies also have made signing up for Medicaid online more mobile and personal. For example, all 50 states with an online application, applicants can now start, stop and return to finish the application at a later time. In addition, state Medicaid agencies have increasingly added the ability for individuals to upload electronic copies of documentation with their application if needed. Between 2013 and 2018, the number of states with this functionality grew from 15 to 34, including Utah, which added this option in 2017, Kaiser says.
Other report findings include:
- More mobile. In more than half of states, individuals can access online applications and accounts through mobile devices, but many of the applications and accounts do not have mobile-friendly formatting. As of January, individuals in 31 states can complete and submit the online Medicaid application through a mobile device and 11 of these states have app. In 30 of the 42 states where Medicaid recipients already have an online account, enrollees can access their account through a mobile device and 14 of these states have apps for a mobile-optimized site.
- More web features. Many states provide online accounts for enrollees to manage their Medicaid coverage, and states have expanded the features and functions of these accounts over time, Kaiser says. Online accounts create administrative efficiencies by reducing mailing costs, call volume, and manual processing of updates such as an address change. They also provide enrollees increased autonomy to manage and monitor their coverage. Between 2013 and 2018, the number of states providing online accounts grew from 36 to 42.
- Growing portals. Just over half of the states (27) have a web portal or secure login that enables consumer assisters to submit applications on behalf of consumers they help.
- Faster verification. 40 states are able to make real-time Medicaid eligibility determinations within 24 hours.
- Expedited electronic forms. 45 states use pre-populated forms to facilitate renewal when a state is not able to complete an automatic renewal through electronic data sources.In 14 states, the state populates the form with updated sources of data from electronic data matches.
“Since the ACA was enacted, states have invested significant time and resources to upgrade or build new eligibility systems and re-engineer their business processes,” Kaiser says.
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