OSP Opposes CMS’s Proposed “Streamlining Medicaid Eligibility” Rule

Tallahassee, FL — Today, Opportunity Solutions Project (OSP) publicly commented on a proposed rule by the Centers for Medicare & Medicaid Services (CMS), which, if enacted, would effectively lock in the COVID-19-era policy that prevents states from removing the more than 21 million ineligible Medicaid recipients from the program.

CMS claims this new rule would “streamline eligibility and enrollment processes for all Medicaid and Children’s Health Insurance Program (CHIP) populations and create new enrollment pathways to maximize enrollment and retention of eligible individuals.”

In its comment, OSP refutes these claims made by CMS, and argues that the Medicaid program is already wrought with waste, fraud, and abuse—more than one in five dollars is spent improperly—and this “unlawful, illogical, and extraordinarily harmful” rule will only do further damage to the safety net and state budgets already stretched thin by expansion. Among the rule’s many issues is the emphasis on “maximizing enrollment” over program integrity. The rule strips away important measures, including regular eligibility reviews, in-person interviews, and follow up on address changes. The proposed rule would continue to divert resources away from the truly needy toward individuals who could obtain coverage elsewhere, at tremendous new cost to state and federal taxpayers.

“CMS’s proposed rule is an illegal overreach by the federal government and blatantly disregards the hard work states are doing to protect their Medicaid programs for the truly needy who rely on them,” said Sam Adolphsen, OSP Visiting Fellow and co-author of the public comment. “It’s clear that the Biden administration wants anyone and everyone on Medicaid, regardless of need and no matter the impact on state budgets. State governments would be wise to remove the pandemic-era funding handcuffs from their Medicaid programs should this rule go into effect.”


The Opportunity Solutions Project is a non-profit, non-partisan advocacy organization that specializes in health care, welfare, and workforce reform.