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A Voice for Private Physicians Since 1943

Using Past Income Data to Verify Current Medicaid Eligibility

Summary of Urban Institute health policy study provided by The Market Institute.

The Urban Institute released a study this month outlining a new method to determine financial eligibility for Medicaid coverage. Presently, the eligibility determination is undergoing a change because of the Affordable Care Act. In years past, information would be submitted and verified by hand. Now, automated systems will receive the data and make the determination. The Urban Institute has found a way that bypasses the need for consumer information by using a combination of state’s prior year tax records, then reports later in the year about whether particular consumer started new jobs, and finally accessing wage records from the beginning of the calendar year.

Analyzing data from the 2008 Survey of Income and Program Participation (SIPP) lets them establish a probability of current Medicaid eligibility for people with certain levels of past income. States could have different probability thresholds for eligibility and renewals, but the figures used in the study tend to be on the high side of any expected threshold. By forgoing paperwork, using ancillary financial data to determine eligibility would save on administrative costs, cut down on red tape for consumers, safeguard personal data, increase participation, and increase the number of accurate outcomes.

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