Michigan's computer-run Medicaid eligibility system, operated under contracts worth approximately $768 million by the consulting giant Deloitte, has repeatedly and incorrectly denied or misdirected disabled residents away from the benefits they are legally entitled to receive, a KFF Health News investigation published July 20, 2026 has found. The problems documented in Michigan include the system incorrectly enrolling disabled people in a skimpier benefits plan not designed for them, denying coverage to working disabled adults whose earnings the system miscalculated, and failing to recognize specific Medicaid eligibility rules that apply only to people with disabilities.
Deloitte does not operate only in Michigan. The same company holds contracts to build or run Medicaid eligibility systems in at least 25 states, according to KFF Health News, making it the dominant private vendor in the government business of determining who can access safety-net health coverage.
Why This Matters
More than 90 million Americans are enrolled in Medicaid, and people with disabilities represent one of the most medically vulnerable groups in that population. For them, Medicaid is frequently the only insurance pathway to the specialized care, medications, and support services their conditions require. A system that incorrectly calculates eligibility does not simply create administrative inconvenience. It interrupts the prescriptions that manage someone's heart rate, the specialty appointments that monitor a chronic disease, and the community support services that allow someone to live independently rather than in an institution.
Marie Noon, a former bank manager in Michigan diagnosed with adult-onset Still's disease, a rare inflammatory arthritis, takes eight medications daily. When Michigan's Deloitte-run system denied her Medicaid coverage in 2025 despite her eligibility, she paid hundreds of dollars out of pocket for medications she could not otherwise afford. It took months of appeals before the state reversed its error. "I just wanted to give up," Noon told KFF Health News.
What We Know So Far
The KFF investigation, reported by journalist Kate Wells, reviewed contracts, public records obtained through FOIA requests, court documents, and interviews with disability rights attorneys and enrollees. Key documented findings:
Deloitte has operated Michigan's Medicaid eligibility system, called Bridges, under contracts totaling roughly $768 million since 2006, according to contracts reviewed by KFF Health News. For some people with disabilities, federal Medicaid rules require that only half of their earned income be counted when determining eligibility, because many disabled adults can only work part-time and earning modest wages should not eliminate their medical coverage. Michigan's system was incorrectly counting full income amounts, making these people appear ineligible when they were not.
The system was also automatically enrolling some disabled enrollees in "Plan First," a Medicaid plan designed for a different population and offering far more limited coverage than what disabled adults need. "These enrollees had 'long received Medicaid due to their disability,' and getting enrolled in the wrong plan meant losing access to 'services essential to their recovery and quality of life,'" wrote Malcolm Kletke, a lobbyist for mental health providers, in a September 2024 letter to a Michigan health official, obtained by KFF through a public records request.
State records show that Medicaid enrollment in the category for people with disabilities fell by 10% in Michigan over roughly four years, according to the Michigan House Fiscal Agency.
Similar problems have been documented beyond Michigan. A class-action lawsuit in Tennessee centered on comparable problems with a Deloitte-operated system, and KFF obtained records suggesting related issues occurred in Texas.
Deloitte and Michigan's health department did not respond to detailed questions from KFF Health News.
Where the Risk Is Concentrated
The 25 states where Deloitte holds contracts to build or run Medicaid eligibility systems have not been comprehensively named in the KFF investigation, though the firm itself has cited operating in 31 states in its own bid documents. The investigation focused on Michigan as the most thoroughly documented case, but disability rights advocates quoted in the investigation expressed concern that the problems it uncovered likely extend beyond Michigan.
The risk is concentrated in:
- Disabled Medicaid enrollees who work part-time and depend on the half-income counting rule
- Disabled adults who have recently received a new denial notice or been redirected to a different Medicaid plan
- People who attempted to enroll or re-enroll in Medicaid in Michigan or states with similar Deloitte-run systems in recent years
- Any enrollee who received a Medicaid eligibility determination through an automated computer system without human case-worker review
What Disability Rights Experts Say
Anastassia Kolosova, a supervising attorney with Disability Rights Michigan who helped Marie Noon navigate the appeal process, told KFF Health News she has seen multiple wrongful coverage denials and fears the problem is about to become significantly worse.
Her concern centers on new work-reporting requirements in the federal legislation known as the One Big Beautiful Bill Act. The law adds new documentation and reporting requirements for Medicaid enrollees, which the automated systems must process and interpret correctly. If the same systems that are miscounting income are now required to process more complex eligibility determinations under more demanding conditions, the number of wrongful denials is likely to increase.
"There's something wrong with the system if they're relying on individual caseworkers to catch" errors made by the automated system, Kolosova told KFF Health News, describing the operational reality in which human oversight functions as a backup for computer errors rather than as primary case management.
What the Evidence Shows and What It Does Not
MedicalDaily Evidence Check
- Source: KFF Health News investigative report by journalist Kate Wells; published July 20, 2026
- States confirmed: Deloitte contracts confirmed in at least 25 states (Deloitte's own bid documents cite 31 states)
- Michigan contract value: Approximately $768 million since 2006
- Documented errors: Incorrect income counting (full income instead of half-income for disabled workers); automatic enrollment in wrong plan (Plan First instead of disability Medicaid)
- Michigan disability Medicaid enrollment change: Down 10% over approximately four years per Michigan House Fiscal Agency
- Other states with documented problems: Tennessee (class-action lawsuit); Texas (records and interviews cited by KFF)
- Deloitte and Michigan response: Both declined to respond to detailed questions from KFF Health News
- What it shows: Systematic errors in automated eligibility determinations that have denied or misdirected legally entitled disabled Medicaid recipients in Michigan, with evidence of similar patterns in at least two other states
- What it does not prove: The exact number of people wrongly denied, or whether all 25-plus states with Deloitte contracts have the same specific errors; those investigations are ongoing
- What readers should know: Disabled Medicaid enrollees who have received a denial or plan redirection should ask specifically whether their determination was made by an automated system, request case-worker review, and contact their state's disability rights organization for assistance if needed
Who Is Most at Risk?
The people most directly at risk from these system errors are:
- Working disabled adults who earn modest income and depend on the half-income counting rule for Medicaid eligibility
- Disabled Medicaid recipients who received an unexpected plan change or denial notice in recent months
- People with complex eligibility situations, including those with both disability status and part-time employment, who require multiple eligibility rules to be applied correctly simultaneously
- Disabled enrollees in any state where Deloitte operates the Medicaid eligibility system and where case-worker review has been reduced in favor of automated determinations
Symptoms of Denied Benefits to Watch For
For disabled Americans and their advocates, the warning signs of a potential system error in Medicaid eligibility include:
- A denial notice citing income that exceeds the eligibility limit, when the applicant earns only modest part-time income
- An automatic enrollment in a plan the applicant did not select and that does not cover their specialists or medications
- A sudden plan switch without a clear explanation
- A notification that services previously covered are no longer included in their plan
- Denial letters that do not specifically reference the Medicaid rules for disabled workers
Anyone who receives a denial or unexpected plan change should request a written explanation of the determination and ask specifically whether the determination was made by an automated system. They have the right to appeal.
What You Can Do Now
- If you are a disabled Medicaid enrollee and have received a recent denial or unexpected plan change, request a written notice with a full explanation of the eligibility determination and specifically ask whether it was made by an automated system.
- File an appeal. Medicaid enrollees have legal appeal rights when denied benefits. Deadlines for filing appeals are typically short (often 30 to 90 days), so act quickly.
- Contact your state's Disability Rights organization for free legal assistance. Each state has a Protection and Advocacy (P&A) organization mandated under federal law to provide free legal advocacy for people with disabilities. Find your state's organization at NDRN.org .
- Contact your state Medicaid office directly and ask for case-worker review of your eligibility determination, rather than accepting only an automated system decision.
- Read the full KFF Health News investigation at kffhealthnews.org for the documented specifics, including which eligibility rules are most often miscalculated.
- If you are a disabled adult who works part-time, confirm with your state Medicaid office that it is applying the correct half-income counting rule to your case.
Cost and Access: What Patients Should Know
Disability Rights organizations in every state provide free legal assistance for Medicaid-related appeals and eligibility disputes. If your appeal is denied at the state level, further appeals can be made to federal Medicaid oversight through CMS. Many disability rights attorneys also take cases on a contingency or pro bono basis when systemic errors can be demonstrated.
The National Health Law Program (NHeLP) at healthlaw.org maintains legal resources specifically for Medicaid beneficiaries facing wrongful denials.
What Happens Next
The KFF Health News investigation is expected to trigger legislative attention at the state level, particularly in Michigan where the documentation is most detailed. Disability rights organizations in states with Deloitte-run systems are reviewing whether comparable errors exist in their states. The implementation of new work-reporting requirements under the One Big Beautiful Bill Act creates a near-term deadline by which these system errors must be identified and corrected, or they will compound in the rollout of the new requirements. MedicalDaily will report on state and federal responses to the investigation and on any additional states where similar errors are confirmed.
The Bottom Line
A KFF Health News investigation has documented systematic errors in Deloitte-operated Medicaid eligibility systems that have wrongly denied or misdirected disabled Americans away from coverage they are legally entitled to in Michigan, with evidence of similar problems in at least two other states. Deloitte holds contracts in at least 25 states. New federal work-reporting requirements may make these systemic errors more consequential as more disabled enrollees are subject to automated eligibility checks. Any disabled Medicaid enrollee who has received an unexpected denial or plan change should appeal immediately and contact their state Disability Rights organization for free legal assistance.
