To get health care, many must navigate glitchy government technology : Shots

Eric Harkleroad/KHN (Images: Getty Images/Unsplash)

(Eric Harkleroad/KHN illustration; Unsplash; Getty Images)

Eric Harkleroad/KHN (Images: Getty Images/Unsplash)

In October, when Jamie Taylor’s household monthly income fit within new state income limits after Missouri’s 2021 expansion of Medicaid, she applied for health coverage. She received a rejection letter within days, stating that her earnings exceeded the acceptable limit.

It was the latest blow in Taylor’s ongoing campaign to get assistance from Missouri’s safety net. Taylor, 41, has spent hours on the phone, enduring four-hour hold times and dropped calls. Time-sensitive documents were mailed to her home in Sikeston but by the time they arrived she had little time to act.

Her latest rejection – she would later find out – resulted from a preprogrammed glitch in her application that a technician enrolling her failed to catch.

Taylor’s struggles to get a benefit she was in fact qualified for are not uncommon in Missouri or nationally. They stem from extremely outdated technology used by a humongous web of government agencies, from local public health to state-run benefits programs. Matt Salo, the National Association of State Medicaid Directors executive director, calls the need for technology upgrades “the next great challenge that government has to solve.”

The COVID crisis exposed just how antiquated and ill-equipped many systems are to handle the unprecedented demand. While private-sector businesses beefed up the ability to stream TV shows, created apps for food deliveries, and moved offices online, some public health officials tracked COVID outbreaks by fax machine.

Jamie Taylor dealt with four-hour hold times and dropped calls while trying to secure public benefits in Missouri. Others have encountered similar problems across the nation as the pandemic has highlighted the pitfalls of dated government technology.

Krissy Pruiett


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Krissy Pruiett


Jamie Taylor dealt with four-hour hold times and dropped calls while trying to secure public benefits in Missouri. Others have encountered similar problems across the nation as the pandemic has highlighted the pitfalls of dated government technology.

Krissy Pruiett

But momentum is finally building for government tech updates. With once-in-a-generation pools of money available from pandemic relief funding and higher than expected tax revenues, some efforts are underway. President Joe Biden issued an executive order in December calling on benefits enrollment to be streamlined. State lawmakers are urging the use of unspent COVID relief money to address the issue.

That’s critical because outdated information systems can trigger ripple effects throughout the public benefits system, according to Jessica Kahn, who is a partner at the McKinsey & Co. consulting firm and previously led data and systems for Medicaid at the Centers for Medicare & Medicaid Services. One example: Hard-to-navigate online benefits applications can push more applicants to call phone help lines. That can strain call centers that, like many industries, are having difficulty meeting staffing needs.

Some states are already eyeing improvements:

In Wisconsin, Democratic Gov. Tony Evers has directed up to $80 million to replace the state’s old unemployment infrastructure.

Kansas is among the first states working with the U.S. Department of

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