On May 18, the House Budget Committee (HBC) advanced a multi trillion-dollar budget reconciliation package.

While there are a number of policies in the package that raise serious concerns – including over $1 trillion total cuts to healthcare programs with $700 billion worth of detrimental cuts to federal Medicaid funding alone – our team at Responsive Gov wants to highlight a critical addition that we suggested to electeds last month: language mandating the establishment of a new federal system that would streamline list maintenance for Medicaid enrollment (Section 44103). The proposed system would mirror an existing, highly effective system used by a group of states to keep voter rolls up to date, the Electronic Registration Information Center (ERIC).

Creating a similar, secure data-sharing system for Medicaid would be a gamechanger for the nation’s largest health insurance program. As the federal government undertakes sweeping budget cuts and a number of other DOGE-led initiatives in the name of government effectiveness, the HBC’s proposed Medicaid enrollment system presents an actual opportunity to reduce wasteful duplicate enrollments, boost efficiency, and save billions of tax dollars.

How would the system work?

Similarly to ERIC, states would securely submit specific data on Medicaid enrollees to the established system monthly. The system would in turn notify states if an individual is enrolled in Medicaid in any other state(s), reducing waste by ensuring individuals are only enrolled in the appropriate state program.

How would it be funded?

Section 44103 calls for the Secretary of Health and Human Services to “establish a system to be utilized by the Secretary and States to prevent an individual from being simultaneously enrolled,” by October 1, 2029. The section also allocates funding for the Secretary to implement and maintain the system.

How much money would it save?

The Congressional Budget Office estimates the HBC’s proposed system would save:

• $5.8 billion for taxpayers per year
• $2.32 billion for states per year
• $3.48 billion for the federal government per year

For a full analysis on the benefits of creating an ERIC-like system for Medicaid, read “Cross-Sector Innovation: Translating Election Tech into Medicaid Savings” by Responsive Gov fellow Dan Meuse.