Medicaid: Additional Enrollment and Expenditure Data for the Transitional Medical Assistance Program

What GAO Found

Why GAO Did This Study

Transitional Medical Assistance (TMA) is a Medicaid program that offers up to 1 year of additional Medicaid health insurance benefits for certain low-income families who would otherwise lose coverage. Specifically, under TMA provisions that are subject to reauthorization, families who would otherwise lose Medicaid eligibility because of earned income or hours of employment, or the loss of a time-limited earnings disregard, receive at least 6 months and up to 12 months of Medicaid coverage. However, because little is known about TMA enrollment and expenditures within each state, Congress had asked us to provide more information to inform deliberations on reauthorization. To this end, we issued a report in December 2012, which included information about states' TMA program policies, enrollment, and expenditures beginning in 2006 through the most recent year available.

To obtain the information for our December 2012 report, we sent an electronic survey to the Medicaid Director, or his or her designated staff, in all 50 states and the District of Columbia to obtain key information about their respective TMA programs. While 45 states responded to at least a portion of the survey, some states were not able to provide the information we requested, or were not able to provide the information within the time frames of our work. However, our December report noted that for 2011, 41 states reported TMA enrollment of over 3.5 million individuals, and 32 states reported TMA total expenditures of about $3.9 billion.

After we completed the analysis for the December 2012 report, four states that had responded to our survey provided additional information. Specifically, two states (Virginia and Washington) provided TMA enrollment data, and four states (Arkansas, North Dakota, Virginia, and Washington) provided TMA expenditure data. Congress asked us to update the survey results to include these data. With these states included, TMA enrollment in 2011 totaled over 3.7 million in the 43 states that provided enrollment data, and TMA expenditures in 2011 totaled about $4.1 billion in the 36 states that provided expenditure data, which is about $241 million higher than what we originally reported.

This update is based on our work for the December 2012 report and our analysis of the subsequent survey responses, and was conducted in accordance with generally accepted government auditing standards.

For more information, contact Carolyn L. Yocom at (202) 512-7114 or yocomc@gao.gov.