States are paying contractors like Deloitte, Accenture and Optum millions of dollars to help them comply with the One Big Beautiful Bill Act — a law that would strip safety-net health and food benefits from millions of people.
State governments rely on such companies to design and operate computer systems that assess whether low-income people qualify for Medicaid or food assistance through the Supplemental Nutrition Assistance Program, commonly known as food stamps. A KFF Health News investigation found state systems have a history of errors that could cut off benefits for eligible people.
States are now rushing to update their eligibility systems to comply with President Donald Trump’s sweeping tax-and-spending law. The changes would add red tape and restrictions. According to state documents obtained by KFF Health News and interviews, they are coming at a heavy price — both in costs to taxpayers and in coverage losses.
Documents show government agencies spent millions to save huge sums by removing people from health benefits. While states sign eligibility system contracts with companies and work with them to manage updates, the federal government foots most of the bill.
The law’s Medicaid policies will cause 7.5 million people Becoming insurance-free by 2034, according to the nonpartisan Congressional Budget Office. Roughly speaking 2.4 million people Children will also lose access to monthly cash assistance for food.
In five states alone, Company estimates developed A review by state officials and KFF Health News shows the changes would cost at least $45.6 million combined.
The law requires most states to tie Medicaid coverage to employment for some adults, and impose other restrictions that make it harder for low-income people to remain enrolled. SNAP restrictions begin taking effect in 2025. Key Medicaid provisions will begin later this year.
Documents prepared by the consulting firm Deloitte anticipate that a pair of computer systems will replace Medicaid work requirements in Wisconsin. Two other changes related to the state’s SNAP program would cost an additional $4.2 million, according to the documents. Deloitte drafted For the Wisconsin Department of Health Services.
In Iowa, changes to the Medicaid system are expected to cost at least $20 million, According to an estimate prepared by AccentureA consulting company that operates the state’s eligibility system.
Optum – which operates the platform used by Vermont residents to sign up for Medicaid and marketplace health plans under the Affordable Care Act – guessed so cost roughly $1.8 million Evaluating and incorporating new health coverage restrictions.
Initial changes in Kentucky, which has had a contract with Deloitte since 2012, to pass Cost State $1.6 million. And in Illinois, Deloitte estimates revisions It will cost at least $12 million.
