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Outdated Medicaid Rolls May Tell Us Something About Outdated Voter Rolls

The election in Georgia has led to charges of racism and voter suppression. Or maybe it’s just good governance. 

Georgia Secretary of State Brian Kemp, who is the GOP candidate for governor, has used his time in that office trying to clean up the state’s voter rolls. 

The New York Times, citing the Brennan Center for Justice, claims, “Kemp purged 1.5 million voters from its rolls between 2012 and 2016. The Atlanta Journal-Constitution reports that an additional 665,000 Georgia voters were purged last year.” 

Concerns were also raised about an “exact match” provision, which flags a voter “if the personal information on their voter registration form doesn’t exactly match the information from the state's Department of Driver Services or the Social Security Administration,” according to The Hill

We won’t comment on the merits or demerits or motives behind any specific state’s voter roll clean-up efforts, but the Medicaid program does provide evidence that states have done a terrible job at maintaining accurate rolls. And the latest example comes from California. 

The LA Times reports that a recent state audit found, “California spent $4 billion on Medi-Cal coverage between 2014 and 2017 for people who may not have been eligible for the government-funded health plan.” 

The Times continues, “The audit found 453,000 beneficiaries who were marked as eligible in the state’s system, but not in the counties’—indicating that they may not have actually been eligible for Medi-Cal [i.e., Medicaid]. These beneficiaries may have died, moved or begun making more money and no longer qualified for Medi-Cal.” 

This story echoes an op-ed I wrote for the Wall Street Journal four years ago. Illinois had contracted with a private sector company, Maximus, to examine the state’s Medicaid rolls. “Maximus recommended removing 249,912 cases by the end of February 2014, according to the state.” 

As with voter rolls, people being improperly listed on the Illinois Medicaid rolls didn’t necessarily indicate fraud. People had moved out of state, some had obtained employer-provided coverage or perhaps simply turned 65 and enrolled in Medicare without having informed the state. And about 8,000 had died. But there were also people who were not eligible to be on the state’s Medicaid rolls. 

Outdated Medicaid rolls highlight the very real problem of states managing their data. Private sector companies are expected to manage their data and keep it up to date. Shouldn’t we expect the same from the government? 

State officials trying to clean up their Medicaid rolls are sometimes accused of going after the poor. State officials trying to clean up their voter rolls are increasingly accused of voter suppression. Both of them may simply be due diligence in trying to protect taxpayers—and voters.