Medicaid changes look like $160 million and mounds of paperwork
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Nearly 300,000 pieces of paper related to applications for Medicaid and other forms of public assistance passed through the government office in rural Stearns County, Minnesota, last year.
Why it matters: That figure will grow exponentially once Republicans' sweeping overhaul of Medicaid takes effect, Melissa Huberty, administrator of the county's human services department, tells Axios.
- The office is already drowning in paperwork and about 30,000 phone calls a month, Huberty says.
State of play: Roughly one-third of states, including Minnesota, delegate at least some of the work of vetting and processing Medicaid applications to counties.
- Over $160 million a year is what Minnesota's Department of Human Services estimates the additional paperwork related to the work reporting requirements alone will cost its local, state and tribal governments.
Friction point: Without additional state and federal funds, cash-strapped counties may have to raise property taxes to help cover the costs.
- "Eventually it's going to come down to a decision of how much do you want to pay in taxpayer dollars to process all the paperwork," Huberty says.
Between the lines: Antiquated technology makes enrolling people in Medicaid a time-consuming task.
- When a Minnesotan fills out an online application via the state's MNbenefits site, the system spits out a paper form that a county worker then needs to manually input into their system.
Upgrading those systems statewide would cost hundreds of millions of dollars that counties don't have, Association of Minnesota Counties executive director Julie Ring tells Axios.
- And there's no way such an undertaking would be done by the Jan. 1, 2027 start date for the Medicaid changes.
Friction point: Even if county workers can keep up, Huberty fears the new requirements will result in many people who should be eligible losing coverage due to paperwork errors or missed deadlines.
- She estimates that 75% of the forms submitted now contain outdated or incorrect information.
What we're watching: In late May, the office started using an AI virtual assistant called "Eva" to answer calls and read required disclosures to the human on the other end of the line.
Since then, Eva has "fielded" over 5,000 calls — the equivalent of 148 hours of staff time.