Senators Demand Answers on Equifax Plan to 'Profiteer' Off GOP's Medicaid Work Requirements

Three of the US Senate's top critics of corporate greed and anticompetitive behavior are investigating a scheme by credit report firm Equifax that they say will allow the company to profit from Republican policies that are set to rip away healthcare coverage and food assistance from millions of Americans.

Sens. Elizabeth Warren (D-Mass.), Ron Wyden (D-Ore.), and Bernie Sanders (I-Vt.) wrote to Equifax CEO Mark Begor on Tuesday with several questions about the company's anticipated profits from provisions in the One Big Beautiful Bill Act (OBBBA) that imposed work requirements on recipients of Medicaid and Supplemental Nutrition Assistance Program (SNAP) benefits.

Begor told investors last summer that the policy presented a "massive" business opportunity for Equifax, as a product owned by the company called the Work Number is used by many states to instantly verify the wages and work hours of Medicaid applicants.

At least 99 million workers across the country are covered by Equifax's database, which the company has filled with data through exclusive contracts with employers and payroll firms. Equifax has frequently imposed steep price hikes on the product and has been accused of having a monopoly on providing income data to state agencies.

North Carolina's Medicaid program was hit with a 24% price increase in 2022 and a 36% hike in 2024.

"We have very little leverage and recourse to back out," state Medicaid director Jay Ludlam told the New York Times in November.

Luke Farrell, a former employee of the US Digital Service under the Biden administration, told the Times that Equifax owns "a product that has become a core piece of the safety net. I’ve never seen another vendor do such price hikes across public benefits.”

With the new work requirements set to go into effect in January 2027, states will be required to check the database more frequently.

The OBBBA's $1 trillion in cuts to SNAP and Medicaid are projected to cause "over 5 million people to lose their health insurance and over 3 million people to pay higher grocery prices within the next few years," wrote the senators this week.

"But for Equifax, these new threats to Americans’ food assistance and health insurance coverage 'represent the chance to become a lot richer,'" they wrote, quoting the Times' article from November about Equifax's plan to price-gouge states.

The senators continued:

Because Equifax is already dominant in this market, the law’s new red tape requirements allow the company to consolidate power even further, using extractive contracts to price-gouge states, squeeze competitors, and drive up profits. In fact, Equifax is laying the groundwork to cash in by proactively building out a platform called “TotalVerify,” which is specifically marketed as a tool to help “Prepare Your Agency For H.R.1.” Equifax also pitched the platform as a “single-source” for states and government agencies to be able to verify employment, income, incarceration status, consumer address, and phone number history and claims to “help state and government agencies manage the complexities of SNAP and Medicaid programs.” Given that Equifax’s tight grip on this business has “border[ed] on a monopoly,” Equifax stands to gain even more as OBBBA’s red-tape requirements take effect nationwide.

The lawmakers noted that judging from history, the work requirements are unlikely to "be effective at anything but increasing red tape," as the vast majority of Medicaid and SNAP recipients who are eligible to work already do and states have already run "failed" experiments with Medicaid work requirements.

In 2018, Arkansas' program resulted in 18,000 low-income people losing coverage in under a year, with people who had no home internet access and those who qualified for an exemption from the work requirement most likely to lose their benefits.

"Now, President Trump and Republicans in Congress have expanded this policy in a move that will ensure more Americans get tangled up in red tape and lose essential healthcare coverage and food assistance as a result," wrote Warren, Wyden, and Sanders. "That these requirements could allow Equifax to profiteer off of this ‘solution’ [makes] them even more egregious."

Adam Gaffney, former president of Physicians for a National Health Program, summarized the senators' objections to Equifax's price-gouging practices: "Corporate consultants and vendors are getting to make a killing off of Medicaid work requirements' administration machinery while our patients will lose healthcare and suffer. Meanwhile taxpayers will fund the bureaucratic lard."

The senators demanded to know Equifax's per-query costs for each state contract for the Work Number, the number of OBBBA-related contracts it expects to bid for in 2026 and 2027, the company's lobbying expenditures over the past five years for federal, state, and local governments, and whether Equifax plans to retain a clause in its contracts that allows it the “categorical right” to change prices with 30 days’ notice.

"Equifax’s long history of anti-competitive behavior," said the senators, "raises serious concerns about the company’s potential moves to price gouge states and taxpayers."