Dems press Medicaid contractors over eligibility determination systems

By Paige Minemyer / October 15, 2025

Several key Democrats are pressing the contractors who will be responsible for processing Medicaid eligibility under work requirements over reported faults in their systems.

Sens. Ron Wyden (Ore.), Elizabeth Warren (Mass.), Bernie Sanders (Vt.) and Raphael Warnock (Ga.) sent letters late last week to four of the largest contractors in this space—Conduent, Deloitte, General Dynamics Information Technology and Gainwell Technologies—seeking further details on payment structures in their contracts, the documentation Medicaid enrollees need to provide and how they update their platforms to account for identified errors.

The Republican-led One Big Beautiful Bill Act established nationwide work requirements for Medicaid, which will take effect in 2027. Under the law, individuals seeking Medicaid must log at least 80 hours of community engagement activities, including employments, community service, job searching or training or education.

“We write out of concern that thousands of eligible Medicaid beneficiaries are erroneously denied coverage each year due to eligibility systems plagued by errors,” the senators wrote in the letters.

“H.R. 1 includes the largest cuts in Medicaid’s history and adds new red tape requirements by requiring states to condition Medicaid eligibility on individuals proving work," they wrote. "The addition of paperwork hurdles, layered onto problematic eligibility systems, will cause Americans to lose Medicaid coverage to this bureaucratic maze.”

The senators said that with the OBBBA taking these eligibility requirements nationwide, it's crucial to understand where there are risks for error and where enrollees can get bogged down in paperwork.

Earlier this year, Wyden and Warren similarly sought to probe Maximus, another large contractor in the Medicaid eligibility space, ahead of the OBBBA's final passage. The pair said the company "has an abysmal track record, with reports of egregious backlogs and service delays and several reported instances of fraud.”