Federal Policy
CMS Renews Data Matching Program for Health Subsidy Eligibility
CMS published a Privacy Act notice establishing a computer matching program between CMS and state-based Administering Entities to support eligibility determinations for Qualified Health Plans, Medicaid, CHIP, and Basic Health Programs under the ACA. The program also supports new statutory requirements for Medicaid community engagement verification and prevention of duplicate Medicaid enrollment across states through the Multi-State Enrollment Prevention system. States and marketplaces use the data exchange to verify applicant eligibility data. The notice takes effect under standard Privacy Act matching program procedures, with the activity dated October 29, 2026.
Why it mattersState Medicaid agencies and marketplaces must rely on this data matching infrastructure to verify eligibility, enforce community engagement requirements, and prevent duplicate enrollment, making accurate implementation essential for compliance and program integrity.