Marie Noon resides in Brighton, Michigan, managing daily life with her dog. Although Marie qualified for Medicaid, she faced a denial in 2025 due to an error within the state’s benefits system. Her persistence eventually led to the reversal of this mistake, but even as a technologically adept former bank manager, Marie encountered significant challenges and moments of doubt. Kate Wells reports for KFF Health News.
Marie toman eight medications daily, with purposes ranging from regulating heart rate to preventing headaches and managing fluid retention. Over ten years ago, Noon was diagnosed with adult-onset Still’s disease, a rare form of inflammatory arthritis causing severe pain, fever, and rashes. The illness significantly altered her life. She transitioned from a typical suburban routine in Michigan, involving extracurricular activities for her children and banking responsibilities, to a situation where attending to basic needs became an ordeal, accompanied by relentless pain.
Noon, now 48 and unable to work for eight years due to debilitating symptoms, experienced prolonged hospital stays and feared for her life. Consequently, Michigan’s denial of her Medicaid application last year, following her loss of private insurance, came as a shock. The error, attributed to an IT issue, necessitated legal intervention to rectify.
“I can’t afford my medical care. I need insurance,” Noon stated, highlighting her reliance on coverage.
Deloitte, an extensive global consulting firm, managed Michigan’s Medicaid eligibility system under contracts valued at roughly $768 million since 2006, as per KFF Health News-reviewed contracts. Nationwide, Deloitte holds similar contracts across at least 25 states, managing systems crucial for safety net benefits such as Medicaid. However, Michigan’s system sometimes misdirects individuals with disabilities into minimal care packages or denies coverage.
Issues arose relating to system errors affecting eligibility, as seen in class-action lawsuits in Tennessee and Texas, supported by interviews, official documents, and public records. Despite Deloitte’s statement dismissing system anomalies, incidents indicate the contrary. Michigan’s Health and Human Services reported no widespread issues within its Bridges eligibility system.
Since signing contracts, Deloitte has been responsible for developing, maintaining, and upgrading the Michigan system. However, impending changes mandated by new federal legislation, known as the One Big Beautiful Bill Act, necessitate swift Medicaid system upgrades to verify employment extras, adding further strain on these systems.
Pamela Herd, a University of Michigan professor studying bureaucratic patterns, emphasizes system stress impacts everyone. Michigan erroneously assessed Noon’s earnings against Medicaid eligibility, failing to recognize her disability status.
“I’m really worried about more people falling through the cracks,” said Anastassia Kolosova, a disability rights attorney, concerned about impending system overburdens.
Noon’s denial led to substantial out-of-pocket expenses for medications, accompanied by uncertainty regarding fluctuating costs. This health care concern also encompassed reduced doctor visits to minimize expenses.
Medicaid, jointly administered by federal and state governments, serves approximately 67 million individuals with low incomes or disabilities. State reliance on firms like Deloitte to establish computer systems is prevalent despite previous investigations revealing errors that deny rightful benefits.
With looming deadlines under pressure from sweeping alterations due to Republican-led federal provisions, firms like Deloitte, Accenture, and Optum receive significant public funds to execute mandatory system changes. Despite exemptions for seniors, children, and disabled individuals, the administrative strain disrupts benefits, per interviews with Medicaid advocates and health care analysts.
In Michigan specifically, a program covers disabled adults who work, focusing on their assessment criteria. The system flaws affected Noon’s profile, and disability classification inconsistencies arose.
Kolosova and others received calls of wrongful coverage denial concerns regarding Freedom to Work benefits while advocating for necessary systemic changes and improvements.
In Texas, similar occurrences were noted. In 2023, Lilly Livingston, a Medicaid beneficiary with Down syndrome, faced unexpected coverage cuts despite necessitating extensive medical services. Deloitte’s involvement in such eligibility systems was again scrutinized.
Michigan advocates reported instances of Medicaid enrollees mistakenly categorized within the limited Plan First program, losing vital aid. Despite state denial of systemic issues, evidence supported advocacy claims, and government audits criticized Deloitte’s initial handling.
KFF Health News has noted broader implications and discrepancies within disabled insurance categories impacting state beneficiaries.
Noon’s perseverance paid off in January, attaining approval after extensive advocacy efforts.
“I literally cried,” she shared, celebrating this milestone.