New Jersey lawmakers on Monday scrutinized the state's handling of thousands of low-income residents' Medicaid applications, as the Christie administration asserted it had made progress in reducing the backlog.
Gov. Christie expanded Medicaid under the Affordable Care Act, and 400,000 residents have gained health insurance through the government program since 2014.
However, thousands of applications have languished at understaffed county welfare agencies, in part because of the state's antiquated computer systems.
"We are very concerned about the backlog," Elizabeth Connolly, acting commissioner of the Department of Human Services, told the Assembly Budget Committee. "We want people to have their Medicaid timely."
Valerie Harr, director of the department's Division of Medical Assistance and Health Services, said the state relied on counties to report their backlogs. But some counties' reporting is infrequent, she said.
That makes it difficult to determine the size of the backlog. A department spokeswoman said the state estimated about 12,000 applications were pending at county welfare agencies.
Under the federal health care law, states are required to determine Medicaid eligibility within 45 days.
Given the incomplete data, "how can you feel confident this backlog has been satisfied?" asked Assemblyman Troy Singleton (D., Burlington).
Administration officials said the state had transferred thousands of applications for procession to Xerox, its contracted health benefits coordinator. The state's contract with Xerox is worth $7 million.
Xerox's work has been a "big help to the counties in moving a lot of the backlog off their desks," Connolly said.
The county welfare agencies' caseload increased from 390,000 in December 2013 to 690,000 in March 2015, according to the department.
In addition to processing new applications, counties must review the status of 450,000 current Medicaid enrollees to determine whether they are still eligible.
The Affordable Care Act expanded eligibility to those who earn up to 133 percent of the federal poverty level, or $32,253 annually for a family of four.
The state contracted with Hewlett-Packard in 2009 to create an integrated computer network for social services. The technology was supposed to help the state process applications and determine eligibility for programs such as Medicaid and Supplemental Nutrition Assistance Program.
But after persistent delays, as well as changing demands resulting from the health care law, the state terminated its $118 million contract with HP late last year. The state paid $142,000 to the law firm Lowenstein Sandler to assist in its settlement with HP, a department spokeswoman said.
New Jersey spent $15 million on the project. This year, it hired consultant KPMG to assess how much of HP's work could be salvaged. The state is paying KPMG $850,000, Connolly said.
KPMG is expected to complete a report by the end of May.