2026-03-30T05:00:10-0400 / https://www.cbsnews.com/news/trump-medicaid-snap-aid-states-consultants/
各州正向德勤、埃森哲、安泰医疗等承包商支付数百万美元，协助它们遵守《宏大美好法案》——这项法案将剥夺数百万美国人享有的社会保障医疗和食品援助福利。
州政府依靠这类企业设计并运营计算机系统，评估低收入人群是否符合医疗补助计划，或是通过补充营养援助计划（通常被称为食品券）获得食品援助。凯撒家庭基金会健康新闻部的调查显示，这类州级系统历来存在失误，可能会切断符合资格人群的福利。
这些面向最贫困美国人的福利，决定着一个人能否获得医疗服务、能否吃饱饭——或是陷入缺医少粮的困境。
据凯撒家庭基金会健康新闻部获取的州政府文件和采访内容，各州目前正竞相更新其资格审核系统，以符合唐纳德·特朗普总统出台的全面税收和国内支出法案。这些调整将增加繁文缛节和限制条款，且代价高昂——既增加纳税人负担，又导致参保人数减少。
文件显示，政府机构将斥资数百万美元，通过削减民众的健康福利节省更多开支。各州与企业签订资格审核系统合同并合作开展更新工作，而大部分费用由联邦政府承担。
无党派的国会预算办公室数据显示，该法案的医疗补助政策将导致750万人到2034年时失去医保。约240万人将失去每月食品现金援助资格，其中包括有子女的家庭。
仅五个州的企业为州政府制定、并经凯撒家庭基金会健康新闻部审核的估算显示，相关调整的总成本至少达4560万美元。
“这绝对是一笔巨额收入，”哈佛大学T.H.陈公共卫生学院健康政策与政治学助理教授阿德里安娜·麦金泰尔说道。
这项为美国最富有人群提供税收减免的法案，要求多数州将部分成年人的医疗补助覆盖与就业挂钩，并增设其他限制条款，进一步降低低收入人群持续参保的可能性。食品援助计划的限制条款已于2025年开始生效，医疗补助的主要条款将于今年晚些时候实施。
咨询公司德勤编制的文件显示，威斯康星州针对医疗补助工作要求的两项计算机系统调整，将耗资近600万美元。德勤为威斯康星州卫生服务部起草的文件显示，该州另外两项与食品援助计划相关的调整将额外耗资420万美元。
爱荷华州的医疗补助系统调整预计至少耗资2000万美元，据运营该州资格审核系统的咨询公司埃森哲编制的估算报告。
安泰医疗——为佛蒙特州居民提供医疗补助和《平价医疗法案》下的医保市场计划平台运营服务——估算，评估并落实新的医保覆盖限制条款将耗资约180万美元。
肯塔基州自2012年起便与德勤签订合同，其初期调整已耗资160万美元。在伊利诺伊州，德勤估算相关修改至少需耗资1200万美元。
历史性的强制要求
1965年林登·约翰逊总统创立政府医保项目后的60年间，国会从未强制要求医疗补助参保者必须就业、志愿服务或上学。
这种情况明年将发生改变。特朗普总统和国会共和党人通过的税收与支出法案，要求42个州和哥伦比亚特区的数百万医疗补助参保者证明自己正在工作，或每月参与类似活动达80小时，除非他们符合豁免条件。国会预算办公室基于法案早期版本预测，将有1850万成年人受新规约束——接近参保总人数的一半。
佛蒙特州卫生服务部副专员阿达琳·斯特鲁莫洛表示，该州预计2027财年将耗资500万美元落实联邦法案要求的调整，其中约180万美元用于安泰医疗调整资格审核系统。安泰医疗是联合健康集团的子公司。
《宏大美好法案》将使近5.5万名佛蒙特州医疗补助参保者受工作要求约束——约占该州参保人数的三分之一。
“这项法案迫使我们几乎搁置了所有其他工作，”斯特鲁莫洛在采访中说道，“这是一项极其艰巨的任务。”
截至10月，安泰医疗与该州的合同价值达1.256亿美元。
凯撒家庭基金会数据显示，全国近三分之二的成年医疗补助参保者已经在工作。医疗补助受助者的维权组织表示，工作要求仍将导致大量人员失去医保。参保者将面临额外的繁文缛节来证明自己合规，而本就容易出错的资格审核系统还需纳入就业、工作相关活动及豁免情况的审核。
国会预算办公室报告显示，受工作要求影响，预计到2034年将有530万参保者失去医保。
在威斯康星州，州官员估算工作要求生效后，约6.3万名成年人可能失去医保。不覆盖这些人群每年可节省5.326亿美元的医疗补助开支。
威斯康星州的医疗补助和食品援助计划资格审核系统名为“CARES”，于1994年在全州范围内启用，据2016年的一份州政府文件，该系统最初是从佛罗里达州迁移而来。
德勤已于9月和12月向该州提交了医疗补助和食品援助计划调整的成本估算。威斯康星州卫生服务部发言人伊丽莎白·古德西特拒绝回答是否需要进行更多调整、落实所有符合新联邦法案要求的资格系统修改将耗资多少，以及该州是否与德勤谈判过价格等问题。
公共利益律师事务所ABC for Health执行主任鲍比·彼得森表示，威斯康星州在帮助民众了解医疗补助资格审核流程方面“投入极少”，而这一流程很快将变得更加复杂。
“但他们却毫不犹豫地斥资600万美元给承包商，打造这些花里胡哨的东西，”彼得森说道，“这正是让我感到愤怒的地方。”
退伍军人和无家可归者面临新障碍
医疗补助工作要求只是特朗普税收法案带来的变化之一，这些变化将让民众更难获得社会保障福利。
从10月起，该法案将禁止多类移民群体享受医疗补助和《平价医疗法案》医保，包括获得庇护的人群、难民以及某些家庭暴力或人口贩运幸存者。从12月31日起，各州必须每年两次核查数百万成年人的资格——这将使州政府官员的工作量翻倍。此外，法案还对食品援助计划设置了限制，要求更多成年受益人必须工作，并取消了退伍军人、无家可归者和前寄养青年的工作豁免。
特朗普总统7月签署法案几天后，肯塔基州卫生官员便迅速对该州的综合资格审核系统进行调整，该系统负责核实医疗补助、食品援助计划等项目的参保资格。德勤根据一份价值超过1.57亿美元的五年合同运营该系统。据凯撒家庭基金会健康新闻部获取的文件，首批耗资160万美元的调整被列为“高度优先”项目并以“紧急”方式获批，其中针对美国最大食品援助项目的部分调整几乎立即生效。
肯塔基州卫生与家庭服务部官员拒绝回答一系列详细问题，包括落实所有必要修改将耗资多少。
德勤发言人凯伦·沃尔什表示，该公司正与各州合作落实新要求，但拒绝回答多个州的成本估算相关问题。“我们正在兑现我们承诺的价值和投入，”沃尔什说道。
在大多数州，政府机构依靠承包商构建和运营决定医疗补助资格的系统。许多州还将这类计算机系统用于食品援助计划。但根据联邦法规，联邦政府——即纳税人——将承担州级医疗补助资格审核系统开发和实施成本的90%，并承担75%的日常维护和运营费用。
“五年、十年前，我不确定是否能听到 Medicaid 主管们太多谈论 SNAP，”华盛顿特区医疗补助主管梅利莎·伯德在11月举行的年度医疗补助官员会议上说道，“尤其是对于像我们这样拥有综合资格审核系统的地区，我现在了解到的食品援助计划知识比以往任何时候都多。”
联邦法案是去年在马里兰州盖洛德国家度假酒店及会议中心举办的年度会议的热门话题，该酒店是新泽西州和佛罗里达州之间规模最大的酒店。
咨询公司也注意到了这一商机。作为会议企业赞助商之一的资格审核承包商Gainwell，将其logo印在了酒店的自动扶梯上。各家企业设立展位，宣传其可如何协助各州，并分发零食和纪念品。
“Conduent 通过智能自动化、数据分析和创新的欺诈预防手段，简化运营、削减成本并推动更好的结果，帮助机构更高效地开展工作，”另一家承包商的宣传手册写道，“我们可以携手，在民众健康保障的每一步更好地服务居民。”康登特公司在密西西比州和新泽西州持有医疗补助资格审核和参保合同，两州的医疗补助机构向凯撒家庭基金会健康新闻部证实了这一点。
德勤的宣传手册中称，该公司在“构建州医疗保健新时代”方面发挥了作用，是“医疗补助计划和技术转型的全国领导者，在联邦、州和商业医疗生态系统中拥有良好记录”。凯撒家庭基金会健康新闻部发现，这家2025财年营收达705亿美元的全球咨询公司，在这一政府业务领域占据主导地位。
“随着医疗补助社区参与（CE）要求的出台，各州面临着新增一项医疗补助资格条件的任务，以支持州和联邦的目标，”另一本宣传手册补充道，“德勤提供战略外联和快速响应支持，帮助各州与社区接触、降低障碍，并解决参保渠道问题。”
爱荷华州2030万美元的账单
在特朗普签署《宏大美好法案》之前，爱荷华州议员就曾试图推行自己版本的工作要求，原本将适用于18.3万名未申请豁免的人群。据运营爱荷华州资格审核系统的埃森哲编制的文件，新法案将迫使爱荷华州修改其医疗补助资格审核系统。该系统合同价值超过6000万美元。
埃森哲2025年3月的估算显示，新增工作状态核查功能的成本最高可达700万美元。到7月，落实《宏大美好法案》工作要求和其他医疗补助条款的成本飙升至约2030万美元。埃森哲的分析称，联邦法案要求爱荷华州的系统进行额外调整。2025年的一份州政府文件显示，若将就业作为医疗补助福利的条件，预计将有3.2万名爱荷华州人失去医保。
削减3.2万人的医保覆盖范围每年可节省1.83亿美元，仅占爱荷华州和联邦政府每年89亿美元医疗补助开支的一小部分。
锡达拉皮兹市的东爱荷华健康中心首席执行官乔·洛克表示，该中心的大多数患者都依赖医疗补助。他质疑政府斥资数千万美元推行一项将爱荷华州人排除在医疗补助之外的政策的逻辑。
该健康中心的大多数患者收入处于或低于联邦贫困线——目前四口之家的贫困线为3.3万美元。
“这部分人群得不到任何好处，”洛克说道。
乔·洛克是爱荷华州锡达拉皮兹市东爱荷华健康中心的首席执行官。该中心的大多数患者都依赖医疗补助。2025年的一份州政府文件显示，若将就业作为医疗补助福利的条件，预计将有3.2万名爱荷华州人失去医保。托尼·莱斯/凯撒家庭基金会健康新闻部
爱荷华州卫生与人类服务部发言人丹妮尔·桑普尔未回答落实该州独立食品援助计划资格系统调整将耗资多少的问题。
在伊利诺伊州，该州今年的工作主要集中在落实《宏大美好法案》的主要条款。伊利诺伊州医疗补助与家庭服务部发言人梅利莎·库拉表示，该州估计多达36万居民可能失去医疗补助，这主要是工作要求导致的。
库拉证实，德勤一份估值1200万美元的报告中涉及的大部分工作都与该法案相关。该估算还提到了其他工作。库拉表示，德巧向该州收取了200万美元与工作要求相关的固定费用。
特朗普政府已经承认，这项工作将产生成本。今年1月，美国医疗保险与医疗补助服务中心（CMS）的高级官员表示，包括德勤、埃森哲和安泰医疗在内的政府承包商已承诺在2028年前提供折扣和优惠费率，协助各州完成系统调整。
“这些企业对此非常兴奋，”CMS医疗补助部门主管丹尼尔·布里尔曼说道，“所有人都专注于推进这项工作。”
CMS发言人凯瑟琳·豪登拒绝回答有关折扣的问题。
威斯康星州医疗补助发言人古德西特拒绝回答德勤是否提供了折扣费率的问题。肯塔基州卫生与家庭服务部官员未回答一系列详细问题，包括德勤是否延长了折扣以推进这些调整。
目前尚不清楚德勤和埃森哲是否向各州提供了折扣，以及具体折扣金额。德勤发言人沃尔什拒绝详细回答特朗普政府今年宣布的折扣相关问题。埃森哲未回应多次置评请求。
佛蒙特州卫生官员斯特鲁莫洛表示，州政府官员已与安泰医疗“详细讨论”了这一公告。
安泰医疗承诺为与医疗补助工作要求相关的特定模块提供折扣。但佛蒙特州认为该产品不可行，因为这意味着“我们在不必更换系统的情况下改用新系统”。当被问及该公司是否提供折扣时，斯特鲁莫洛表示“没有明确说明”。
联合健康集团发言人泰勒·梅森在一份声明中表示，安泰医疗支持各州落实新的联邦要求，“提供一系列选项以满足其独特的成本和政策需求”。
他未具体说明安泰医疗是否为佛蒙特州提供了折扣，以及如何计算其工作成本。“安泰医疗正在帮助减轻前期实施成本，以便各州能够专注于减少重复、加快实施并长期管理成本的方法，为医疗补助覆盖的个人带来更好的结果，”梅森说道。
斯特鲁莫洛表示，安泰医疗在佛蒙特州的初步调整涵盖今年和2027年生效的项目：医疗补助工作要求、每六个月核查一次资格，以及禁止某些移民群体申请医保项目。
“未来可能还有更多调整，”她说道。
凯撒家庭基金会健康新闻部是一家全国性新闻编辑部，专注于健康问题深度报道，也是凯撒家庭基金会的核心运营项目之一——该基金会是独立的健康政策研究、民调和新闻资讯来源。
States pay Deloitte, others millions to comply with Trump law to cut Medicaid rolls
2026-03-30T05:00:10-0400 / https://www.cbsnews.com/news/trump-medicaid-snap-aid-states-consultants/
States are paying contractors such as Deloitte, Accenture, and Optum millions of dollars to help them comply with the One Big Beautiful Bill Act — a law that will strip safety-net health and food benefits from millions.
State governments rely on such companies to design and operate computer systems that assess whether low-income people qualify for Medicaid or food aid through the Supplemental Nutrition Assistance Program, commonly referred to as food stamps. Those state systems have a history of errors that can cut off benefits to eligible people, a KFF Health News investigation showed.
These benefits, provided to the poorest Americans, can mean the difference between someone obtaining medical care and having enough to eat — or going without.
States are now racing to update their eligibility systems to adhere to President Donald Trump’s sweeping tax and domestic spending law. The changes will add red tape and restrictions. They are coming at a steep price ― both in the cost to taxpayers and coverage losses ― according to state documents obtained by KFF Health News and interviews.
The documents show government agencies will spend millions to save considerably more 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 to become uninsured by 2034, according to the nonpartisan Congressional Budget Office. Roughly 2.4 million people will lose access to monthly cash assistance for food, including those with children.
In five states alone, company estimates developed for state officials and reviewed by KFF Health News show that changes will cost at least $45.6 million combined.
“This is a pretty big payday,” said Adrianna McIntyre, an assistant professor of health policy and politics at Harvard’s T.H. Chan School of Public Health.
The law, which grants tax breaks to the nation’s wealthiest people, requires most states to tie Medicaid coverage for some adults to having a job, and imposes other restrictions that will make it harder for people with low incomes to stay enrolled. SNAP restrictions began to take effect in 2025. Major Medicaid provisions begin later this year.
Documents prepared by consulting firm Deloitte estimate that a pair of computer system changes for Medicaid work requirements in Wisconsin will cost nearly $6 million. Two other changes related to the state’s SNAP program will cost an additional $4.2 million, according to the documents, which Deloitte drafted for the Wisconsin Department of Health Services.
In Iowa, changes to its Medicaid system are expected to cost at least $20 million, according to an estimate prepared by Accenture, a consulting firm that operates the state’s eligibility system.
Optum — which operates the platform Vermont residents use for Medicaid and marketplace health plans under the Affordable Care Act — estimated that it could cost roughly $1.8 million to evaluate and incorporate new health coverage restrictions.
Initial changes in Kentucky, which has had a contract with Deloitte since 2012, have cost the state $1.6 million. And in Illinois, Deloitte estimated modifications will cost at least $12 million.
A historic mandate
For six decades after President Lyndon Johnson created the government insurance program in 1965, Congress had never mandated that Medicaid enrollees have a job, volunteer, or go to school.
That will change next year. The tax and spending law enacted by Mr. Trump and congressional Republicans requires millions of Medicaid enrollees in 42 states and the District of Columbia to prove they’re working or participating in a similar activity for 80 hours a month, unless they qualify for an exemption. CBO projected, based on an early version of the bill, that 18.5 million adults would be subject to the new rules — nearly half of those enrolled.
Vermont Medicaid officials expect it will cost $5 million in fiscal 2027 to implement changes in response to the federal law, said Adaline Strumolo, deputy commissioner of the Department of Vermont Health Access. About $1.8 million is for Optum to make eligibility system adjustments. Optum is a subsidiary of UnitedHealth Group.
The One Big Beautiful Bill Act will subject nearly 55,000 Vermont Medicaid recipients to work requirements – about a third of the state’s enrollees.
The law forced the state “to essentially drop everything else we were doing,” Strumolo said in an interview. “This is a big, big lift.”
Optum’s contract with the state was worth $125.6 million as of October.
Nearly two-thirds of adult Medicaid enrollees nationally are already working, according to KFF. Advocacy groups for Medicaid recipients say work requirements will nonetheless cause significant coverage losses. Enrollees will face added red tape to prove they’re complying. And eligibility systems already prone to error will have to account for employment, job-related activities, and any exemptions.
An estimated 5.3 million enrollees will become uninsured by 2034 due to work requirements, the CBO reported.
In Wisconsin, state officials estimate roughly 63,000 adults could lose coverage after work requirements take effect. Not covering those people would save $532.6 million in Medicaid spending for one year.
Wisconsin’s eligibility system for Medicaid and SNAP — known as CARES — was implemented statewide in 1994, and initially was a transfer system from Florida, according to a 2016 state document.
Deloitte submitted its cost estimates for Medicaid and SNAP changes to the state in September and December. Elizabeth Goodsitt, a spokesperson for the Wisconsin Department of Health Services, declined to answer questions about whether additional changes will be needed, how much it will cost to make all eligibility system changes to comply with the new federal law, and whether the state negotiated prices with Deloitte.
Bobby Peterson, executive director of the public interest law firm ABC for Health, said Wisconsin has invested “very little” to help people navigate the Medicaid eligibility process, which soon will become more difficult.
“But they’re very willing to throw $6 million to their contractors to create the bells and whistles,” Peterson said. “That’s where I feel a sense of frustration.”
New hurdles for vets and homeless people
Medicaid work requirements are only one change required by the Trump tax law that will make it harder to obtain safety-net benefits.
Starting in October, the law prohibits several immigrant populations from accessing Medicaid and ACA coverage, including people who have been granted asylum, refugees, and certain survivors of domestic violence or human trafficking. Beginning Dec. 31, states must verify eligibility twice a year for millions of adults — doubling state officials’ workload. And the law restricts SNAP benefits by requiring more adult recipients to work and by removing work exemptions for veterans, homeless people, and former foster youth.
Days after Mr. Trump signed the bill in July, Kentucky health officials raced to make changes to the state’s integrated eligibility system, which verifies eligibility for Medicaid, SNAP, and other programs. Deloitte operates the system under a five-year contract worth more than $157 million. According to documents obtained by KFF Health News, initial changes costing $1.6 million were labeled a “high priority” and approved on an “emergency” basis, with some of the changes to the nation’s largest food aid program going into effect almost immediately.
Officials with Kentucky’s Cabinet for Health and Family Services declined to answer a detailed list of questions, including how much it will cost to make all the modifications needed.
Deloitte spokesperson Karen Walsh said the company is working with states to implement new requirements but declined to answer questions about cost estimates in several states. “We are delivering the value and investments we committed to,” Walsh said.
In most states, government agencies rely on contractors to build and run the systems that determine eligibility for Medicaid. Many of those states also use such computer systems for SNAP. But the federal government — that is, taxpayers — covers 90% of state costs to develop and implement state Medicaid eligibility systems and pays 75% of ongoing maintenance and operations expenses, according to federal regulations.
“Five, 10 years ago, I’m not sure if you would hear much mention of SNAP from a Medicaid director,” Melisa Byrd, Washington, D.C.’s Medicaid director, said in November at an annual conference of Medicaid officials. “And particularly for those with integrated eligibility systems — as DC is — I’m learning more about SNAP than I ever thought.”
The federal law was the topic du jour at last year’s gathering in Maryland, held at the Gaylord National Resort and Convention Center, the largest hotel between New Jersey and Florida.
Consulting companies had taken notice. Gainwell, an eligibility contractor and one of the conference’s corporate sponsors, emblazoned its logo on hotel escalators. Companies set up booths with materials promoting how they could help states and handed out snacks and swag.
“Conduent helps agencies work smarter by simplifying operations, cutting costs and driving better outcomes through intelligent automation, analytics, and innovation in fraud prevention,” read one such handout from another contractor. “Together, we can better serve residents at every step of their health journeys.” Conduent holds Medicaid eligibility and enrollment contracts in Mississippi and New Jersey, their Medicaid agencies confirmed to KFF Health News.
In handouts, Deloitte touted its role in “building a new era in state health care” and as “a national leader in Medicaid program and technology transformation, building a strong track record across the federal, state, and commercial health care ecosystem.” KFF Health News found that Deloitte, a global consultancy that generated $70.5 billion in revenue in fiscal 2025, dominates this slice of government business.
“With Medicaid Community Engagement (CE) requirements, states are tasked with adding a new condition of Medicaid eligibility to support state and federal objectives,” added another brochure. “Deloitte offers strategic outreach and responsive support to help states engage communities, lower barriers, and address access to coverage.”
A $20.3 million bill in Iowa
Before Mr. Trump signed the One Big Beautiful Bill Act, Iowa lawmakers wanted to impose their own version of work requirements. They would have applied to 183,000 people before any exemptions. The new law would necessitate a change to Iowa’s Medicaid eligibility system, according to documents prepared by Accenture, which operates Iowa’s system through a contract worth more than $60 million.
Adding the ability to verify work status would cost up to $7 million, an Accenture estimate from March 2025 showed. By July, the cost to implement the One Big Beautiful Bill Act’s work requirements and other Medicaid provisions skyrocketed to roughly $20.3 million. Accenture’s analysis said the federal law necessitated additional changes to Iowa’s system. An estimated 32,000 Iowans could lose coverage by making employment a condition of Medicaid benefits, according to a 2025 state document.
Cutting 32,000 people from coverage could save $183 million in one year, a fraction of the $8.9 billion Iowa and the federal government spend on Medicaid in a given year.
In Cedar Rapids, most of Eastern Iowa Health Center’s patients rely on Medicaid, CEO Joe Lock said. He questioned the government’s logic of spending tens of millions of dollars on a policy to remove Iowans from Medicaid.
Most of the health center’s patients live at or below the federal poverty level — currently $33,000 for a family of four.
“There is no benefit to this population,” Lock said.
Joe Lock is CEO of the Eastern Iowa Health Center in Cedar Rapids, Iowa. Most of the clinic’s patients rely on Medicaid. By making employment a condition of Medicaid benefits, an estimated 32,000 Iowans could lose coverage, a 2025 state document shows. Tony Leys/KFF Health News
Danielle Sample, a spokesperson for Iowa’s Department of Health and Human Services, did not answer questions about how much it will cost to implement changes to the state’s separate SNAP eligibility system.
In Illinois, the state’s work this year is largely focused on meeting major provisions of the One Big Beautiful Bill Act. The state estimates that as many as 360,000 residents could lose Medicaid, largely due to the work requirements, said Melissa Kula, a spokesperson for the Illinois Department of Healthcare and Family Services.
Kula confirmed that most of the work detailed in one of Deloitte’s estimates ― priced at $12 million ― is related to the law. The estimate also mentions other work. Kula said Deloitte is charging the state a $2 million fixed fee related to work requirements.
The Trump administration has acknowledged that the work is coming at a cost. In January, top officials for the Centers for Medicare & Medicaid Services said government contractors, including Deloitte, Accenture, and Optum, have promised to offer discounts and reduced rates through 2028 to help states incorporate system changes.
“The companies were extremely excited to do this,” said Daniel Brillman, the top CMS Medicaid official. “Everyone’s really focused on getting to work.”
CMS spokesperson Catherine Howden declined to answer questions about the discounts.
Goodsitt, the Wisconsin Medicaid spokesperson, declined to answer questions about whether Deloitte has discounted its rates. Officials with Kentucky’s Cabinet for Health and Family Services did not answer a detailed list of questions, including whether Deloitte extended discounts to make these changes.
It’s unclear what discounts, if any, Deloitte and Accenture have offered to individual states. Walsh, the Deloitte spokesperson, declined to answer detailed questions about the discounts the Trump administration announced this year. Accenture did not respond to repeated requests for comment.
Strumolo, the Vermont health official, said state officials discussed the announcement with Optum “in detail.”
Optum pledged to offer discounts for a specific module related to Medicaid work requirements. That product is unworkable for Vermont because it would mean “moving to a new system when we don’t have to.” When asked about whether the company offered discounts, Strumolo said “not explicitly.”
In a statement, UnitedHealth Group spokesperson Tyler Mason said Optum supports state implementation of new federal requirements “with a range of options to meet their unique cost and policy needs.”
He declined to specify whether Optum discounted Vermont’s rates and how it calculated the costs of doing its work. “Optum is helping mitigate upfront implementation expenses so states can focus on approaches that reduce duplication, accelerate implementation, and manage costs over time — supporting better outcomes for individuals covered by Medicaid,” Mason said.
Strumolo said Optum’s initial changes in Vermont cover items that take effect this year and in 2027 — Medicaid work requirements, checking eligibility every six months, and prohibiting certain immigrants from qualifying for health programs.
“There’s a lot more that could come,” she said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.