Maryland brings in civic technologists to keep eligible people on Medicaid under new work rules

Maryland is working with the civic technology organisations Code for America, Civilla and Public Policy Lab to redesign parts of its Medicaid systems before new federal eligibility rules take effect, StateScoop reported.

From January many adult Medicaid recipients will have to document at least 80 hours a month of work, school, volunteering or other qualifying activity, and states will have to check eligibility twice a year. Maryland has about 1.47 million Medicaid recipients, of whom roughly 320,000 are expected to be affected.

Paperwork as the risk

"Plenty of people who are eligible and are working, but they may lose their coverage because they miss a notice or they don't understand they need to document their hours," said Rebecca Piazza, executive director of safety net strategy at Code for America. "That's the problem that we are really trying to get ahead of."

The partners will redesign member notices, simplify applications and map caseworkers' processes to find repetitive tasks that can be automated or streamlined. Civilla will redesign the state's mobile app and Public Policy Lab will rewrite notices in clearer language.

"We want to give caseworkers more time on the cases that really require their judgment and spend less time on busy work," Piazza said. The project will test interventions with caseworkers and measure whether they reduce administrative work and help eligible people keep coverage.

A lesson from the unwinding

When pandemic-era continuous Medicaid coverage ended, millions of Americans lost coverage for procedural reasons such as unreturned forms rather than ineligibility. Twice-yearly checks and monthly documentation multiply the moments where that can happen. States that invest now in clear notices, data reuse and simple reporting will decide how many eligible people keep their health cover.