A global consulting firm collected $768 million in Michigan taxpayer money to run the state's Medicaid eligibility system, and what disabled residents got for that investment was wrongful denials, coverage gaps, and months of bureaucratic hell to fix errors that never should have happened. KFF Health News has the investigation, and it is not pretty. Deloitte, naturally, says everything is fine.
Meet Marie Noon, Who Nearly Died and Then Got Denied Anyway
Marie Noon takes eight medications a day. One keeps her heart rate stable enough to prevent a stroke. Another stops debilitating headaches. A third keeps her from retaining dangerous levels of fluid. She has adult-onset Still's disease, a rare inflammatory arthritis that had her crawling to the bathroom in agony and spending weeks at a time hospitalized. "I honestly thought I was going to die," she told KFF Health News.
Noon is 48. She's disabled. She hadn't worked for eight years during the worst of her illness. When she finally returned to work and lost her private insurance, she applied for Medicaid through a program specifically designed to cover disabled adults who are employed. She was eligible. The computer system said she wasn't.
According to KFF Health News, the system simply failed to register that she is disabled, then decided she earned too much to qualify under standard Medicaid income rules. An IT error. A box that didn't get checked somewhere in a database that a multibillion-dollar firm was paid three-quarters of a billion dollars to maintain. Noon spent months fighting it, paying hundreds of dollars out-of-pocket for prescriptions she needs twice a day to stay functional. "I can't afford my medical care. I have to have insurance," she said.
Deloitte: Taking the Money, Dodging the Blame
Here's the thing about Deloitte. This is not some scrappy startup that won a contract it couldn't handle. This is one of the largest consulting firms on the planet, pulling in tens of billions of dollars in global revenue annually. And according to contracts reviewed by KFF Health News, they have been running Michigan's Medicaid eligibility system under contracts worth roughly $768 million since 2006. Twenty years. $768 million. And the system is misfiling disabled people into the wrong benefit categories or denying them outright.
When KFF Health News reached out, Deloitte spokesperson Karen Walsh said the company found "no system anomalies causing routine denials of Medicaid for people with disabilities." She added that "there are many reasons why someone may no longer be eligible for a benefit they once received or believe they deserve." That's a remarkable thing to say about someone like Marie Noon, whose eligibility was confirmed by a disability rights attorney and whose denial was eventually reversed by the state. But sure. Many reasons.
Michigan's Department of Health and Human Services backed Deloitte up, saying it "is not aware of any widespread or systemic issues" in the state's benefits system related to disability-based eligibility. The contracts, KFF Health News found, place responsibility for development, implementation, maintenance, operations, and enhancements squarely on Deloitte. So someone built a system that got this wrong. And that someone collected $768 million for the privilege.
This Is Not Just Michigan
Deloitte did not limit this particular business model to one state. KFF Health News found that at least 25 states have awarded the company contracts to build or run computer systems that control access to Medicaid and other safety net benefits. Twenty-five states.
Similar problems were at the center of a class-action lawsuit in Tennessee, according to court documents KFF Health News reviewed. The same kinds of errors have occurred in Texas, based on interviews and state records. The pattern here is not one bad system in one bad state. The pattern is a company that dominates a critical slice of government IT contracting and is producing systems with documented failure modes that strip coverage from people who medically cannot afford to lose it.
Nationwide, roughly 15.5 million people on Medicaid have a disability, according to KFF. These are not people with a lot of margin for error. These are people for whom losing coverage for even a month can mean skipping medications that prevent strokes, seizures, or organ failure. "I'm toast," is how Noon described going without her prescriptions. That's the actual stakes of a bureaucratic IT glitch.
And Now the Federal Government Is About to Make Everything Worse
If the current state of Deloitte's Medicaid systems sounds bad, good news: the Trump administration just mandated changes that will dramatically increase the workload on those same systems. The One Big Beautiful Bill Act, which is now law, requires states to add employment verification requirements to Medicaid, among other changes. States are scrambling to update their eligibility systems to handle this.
Pamela Herd, a University of Michigan professor who studies bureaucratic barriers to accessing government benefits, told KFF Health News exactly what you'd expect a serious researcher to say about this situation: "When these administrative systems get overloaded, everyone gets impacted. The systems are going to be really, really strained."
Anastassia Kolosova, the disability rights attorney who helped Noon overturn her denial, put it more plainly. "I'm really worried about more people falling through the cracks," she said, because the state's benefits system "is going to be even more overburdened than it is right now." A system that already misfiled disabled people before the new requirements hits is now going to absorb a massive increase in verification complexity. What could go wrong.
The Human Cost of 'No System Anomalies'
While Deloitte was finding no anomalies and Michigan was finding no systemic issues, Marie Noon was scrounging for discount coupons to afford the prescriptions keeping her alive. She described the stress of "not knowing if my medicine's going to be $50 or $500" each month. She described wanting to give up multiple times during the months it took to reverse the state's error. This was a former bank manager, someone she herself describes as "tech-savvy." Someone who understood bureaucracy and had the literacy to fight it.
Kolosova, her attorney, has seen multiple wrongful coverage denials. What she's worried about is the people who don't have an Anastassia Kolosova. The people who get a denial letter, don't know they can appeal, don't know a disability rights attorney, and just... stop taking their medications. Those people don't end up in KFF Health News investigations. They end up in emergency rooms, or worse.
Noon said she "just wanted to give up" several times. She is alive and has coverage now because she had the stamina and the legal support to keep fighting. That is a genuinely harrowing thing to reflect on.
The Dingo Take
Let's be very clear about what this investigation describes. A company collected $768 million over two decades from Michigan taxpayers to run a system that controls whether sick and disabled people get healthcare. That system has been documented directing those people into the wrong benefit categories or denying them entirely. The company's response is that there are no anomalies and that there are "many reasons" someone might be denied benefits they deserve. That is not a response. That is a shrug in a suit.
The broader Deloitte angle here is the one that should make you furious. This is not a company that lost a contract and learned a hard lesson. This is a company operating in at least 25 states with the same business model: government IT contracts so large and so entrenched that accountability becomes nearly impossible. Who fires Deloitte? Michigan has been locked in with them since 2006. The switching costs are enormous. So the state says there's no systemic problem, Deloitte says the same, and disabled people spend months proving otherwise with the help of attorneys most of them don't have access to.
And now comes the One Big Beautiful Bill, loading new requirements onto these already-strained systems, with millions more Medicaid recipients about to run the eligibility gauntlet at a time when the people running the computers cannot manage the current load without errors. The Trump administration has decided this is the moment to make Medicaid harder to access. Deloitte, presumably, will be available to help states update their systems for an additional fee.
