Illustration: Annelise Capossela / Axios
A new push is underway for Congress to modernize how Medicaid plans communicate with enrollees, by carving out an exemption from a decades-old texting ban.
Why it matters: Backers of the plan say the policy could help Medicaid plans better inform enrollees about their coverage and what's needed to keep it active as Congress appears poised to pass work requirements.
Catch up quick: Medicaid plans are prohibited from texting members without their consent under a 1991 law intended to protect consumers from automated telemarketers.
- Each text sent in violation of the policy could result in a $500 fine, at minimum.
- The FCC ruled in 2023 as continuous Medicaid eligibility was ending that managed care entities could legally text reminders and updates to enrollees specifically about their coverage.
Exempting Medicaid plans from the law altogether would also let them remind enrollees to get preventive health screenings and generally make it easier for plans to communicate with beneficiaries, said Abner Mason, chief strategy and transformation officer for health care coordination company GroundGame.Health.
- Mason is leading the effort to get the exemption included in the reconciliation package.
What they're saying: "A key strategy for doing the least harm and most good as work requirements [are] implemented is to modernize communication," Mason said. "We've got to get out of the 1991 law and actually communicate like we do in 2025."
- Mason is drafting a sign-on letter to garner support for the effort and has reached out to Senate offices to talk about adding the exemption to the reconciliation package.
- He doesn't anticipate any new spending would be involved. In the long term it should be a cost-saver because digital communication is less expensive than paper mailings, he said.
Between the lines: Medicaid plans can still take advantage of the 2023 FCC policy to text members about enrollment activities, and state Medicaid agencies are also able to text enrollees without prior consent.
- Medicaid plans can also ask for members' consent to text them about other topics.
- But codifying a full exemption for plans from the policy would make it easier for insurers to bring their communication into the modern era and help beneficiaries stay on top of their care, advocates say.
- "Having clarity — purposeful, powerful clarity — in the law would be really, really helpful at this time," said Matt Salo, health care consultant and former executive director of the National Association of Medicaid Directors. "If they can get that done, I think it would be good."
Reality check: Getting the provision into the bill will be an uphill battle with so many other moving pieces in play.
- Health insurance trade groups told Axios they support the idea but indicated that they have other priorities for the bill.
- "Our immediate focus is on protecting the program and the millions who rely on it for their coverage and care," Tina Stow, AHIP executive vice president of external affairs, told Axios in an email.
- Making it easier for Medicaid plans to text members is a step in the right direction, but the Association for Community Affiliated Plans is also keyed in on the new requirements that this bill would add to coverage for low-income people, CEO Meg Murray said in a statement to Axios.
