The United States Digital Services (USDS)-led Data Services team is seeking to reduce the administrative burden of navigating Federal programs using data and technology. The team’s work in 2023 focused on improving Federal services used to verify income during application and renewals, as well as providing direct technical assistance to States managing Medicaid renewals during the unwinding of the national Public Health Emergency.

Income verification as a service. Federally funded, State-administered programs like Medicaid, SNAP, and TANF require income verification as an essential part of eligibility determinations. Electronic verification processes are currently restricted to serving traditional earners (those that receive an annual Federal W-2 tax form) and lack the means for verifying non-traditional earners (those that receive a form 1099, “gig” laborers, and populations that lack specific types of personal information like Social Security numbers). The Income Verification team partnered with CMS and SNAP to pilot technology improvements to the verification process, which aim to reduce administrative burden, expand electronic verifications for all earners, and provide more efficient and integrated service to enable cross-enrollment and minimize duplication of effort (and costs) by State administrators.

The United States Digital Services (USDS)-led Data Services team is seeking to reduce the administrative burden of navigating Federal programs using data and technology. The team’s work in 2023 focused on improving Federal services used to verify income during application and renewals, as well as providing direct technical assistance to States managing Medicaid renewals during the unwinding of the national Public Health Emergency.

Medicaid renewals rapid response. With the unwinding of the national Public Health Emergency, States restarted eligibility renewals for more than 90 million people covered by Medicaid. This renewal volume has caused significant operational challenges for States and placed a considerable burden on Medicaid recipients seeking to renew. To tackle this challenge, USDS deployed a rapid response team to provide direct technical assistance to States to understand and identify opportunities to streamline and simplify State workload and customer experience. Through this work, the Center for Medicaid & CHIP Services (CMCS), USDS, and State partners identified an error in State eligibility systems that resulted in erroneous coverage losses for over 500,000 children and families^[1]. Thanks to the hard work, all 500,000+ people will have their Medicaid coverage reinstated across nearly 30 States. Beyond the resolution of this error, the rapid response team’s efforts on the ground in States have enabled millions of people to be renewed for Medicaid, as required by law, using existing data (ex parte), significantly reducing the burden on individuals and preventing administrative churn^[2], in particular for children. Rapid response teams have also implemented customer experience improvements with State partners, from improving renewal websites to redesigning the envelopes that package mailed notices. 

^[1] https://www.medicaid.gov/sites/default/files/2023-08/state-ltr-ensuring-renewal-compliance.pdf

^[2] Administrative churn occurs when an individual is disenrolled, likely due to the administrative burden of renewal processes, and then re-applies within a short period. Medicaid churning and continuity of care [ASPE, 2021]

In 2023, the Supporting States (“Accelerator”) team collaborated with the Aspen Institute Financial Resilience Program to convene six monthly workgroups focused on remediating delivery barriers States face: data-sharing, operations, policy and requirements, procurement, talent, and text messaging and notifications. Twenty States have attended regular meetings, including Federal staff, stakeholders, and independent experts. States are identifying specific challenges, sharing insights, and beginning to develop valuable resources. The Accelerator team also organized a training led by agency colleagues at the Federal Communication Commission to clarify permissible uses of text messaging to communicate with benefits program participants. The team is developing data sharing and reuse guidance to facilitate State use of Federal and third-party data for verifications. The team is exploring State solutions to address talent needs and better incorporate human-centered design and collection of feedback on lived experiences into program operations. The team is developing other supports for State operations in text messaging, plain language notices, call centers, and account access. The team also conducted research with States and experts to identify and prioritize leading procurement practices for benefits programs for potential Federal pilots to come.