[Medicaid] Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 (CMS-10410)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10410 - Supporting Statement A (2025 version 10).docx	Supporting Statement A	Uploaded 2025-12-19	Available
Cover and Comment - mfl-7lyv-ppil.pdf	Public Comments	Uploaded 2025-09-15	Repair queued
Attachment - mfl-7lyv-ppil.pdf	Public Comments	Uploaded 2025-09-15	Repair queued
CMS-10410 comment response.docx	Supplementary Document	Uploaded 2025-12-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
201666	Periodic Renewal of Medicaid and CHIP Eligibility - Recordkeeping (sections 435.916, 457.343, and 457.350)		Modified
199159	Web Sites (sections 435.1200 and 457.335)		Modified
199158	Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350)		Modified
199157	Periodic Renewal of Medicaid and CHIP Eligibility - Eligibility Notice (sections 435.916, 457.343, and 457.350)		Modified

ICR Details

OMB Control No: 0938-1147	ICR Reference No: 202512-0938-003
Status: Received in OIRA	Previous ICR Reference No: 202203-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No: CMCS
Title: [Medicaid] Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010 (CMS-10410)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/19/2025

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2026
Responses	76,500,218	76,500,218
Time Burden (Hours)	21,266,302	21,266,302
Cost Burden (Dollars)	0	0

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Abstract: The Patient Protection and Affordable Care Act (Pub. L. 111-148, enacted on March 23, 2010) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152, enacted on March 30, 2010) are collectively referred to as the Affordable Care Act. The Affordable Care Act expands access to insurance affordability programs through improvements in Medicaid eligibility, enrollment simplification, the establishment of Affordable Insurance Exchanges ("Exchanges"), and coordination between Medicaid, the Children's Health Insurance Program (CHIP), and Exchanges. Relevant to this Statement, the Affordable Care Act promotes a high level of coordination, simplification, and data sharing among State and Federal agencies for the purpose of a seamless and streamlined eligibility system. The Affordable Care Act allows for significant use of Web-based technology to provide information to the public and facilitate application and renewal functions. It creates a "no wrong door" approach to insurance affordability programs so that individuals will not have to apply to multiple programs. Nor will they have to repeat the application process if they initially apply to a program for which they are not ultimately determined eligible. It also provides a simplified process for maintaining coverage through a streamlined renewal process. The provisions of the Affordable Care Act relevant to this Statement are effective January 1, 2014. The proposed requirements for the collection and reporting of information and recordkeeping (collectively known as information collections) generally relate to ensuring data sharing and coordination among State and Federal agencies, recordkeeping efforts among State agencies, and the development of Web-based systems and notices in support of the implementation of the Affordable Care Act.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1414 Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 148 2002 Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 148 2101 Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 148 2201 Name of Law: Patient Protection and Affordable Care Act
   Statute at Large: 19 Stat. 1902
   PL: Pub.L. 111 - 148 2001 Name of Law: Affordable Care Act
   Statute at Large: 21 Stat. 2102
   PL: Pub.L. 111 - 148 1413 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: Statute at Large: 21 Stat. 2102
PL: Pub.L. 111 - 148 1414 Name of Law: Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 148 1413 Name of Law: Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 148 2101 Name of Law: Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 148 2001 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 2002 Name of Law: Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 148 2201 Name of Law: Patient Protection and Affordable Care Act
Statute at Large: 19 Stat. 1902

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 43189	09/08/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 54694	11/28/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Periodic Renewal of Medicaid and CHIP Eligibility - Eligibility Notice (sections 435.916, 457.343, and 457.350)
Periodic Renewal of Medicaid and CHIP Eligibility - Pre-Populated Renewal Form (sections 435.916, 457.343, and 457.350)
Periodic Renewal of Medicaid and CHIP Eligibility - Recordkeeping (sections 435.916, 457.343, and 457.350)
Web Sites (sections 435.1200 and 457.335)

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	76,500,218	76,500,218	0	0	0	0
Annual Time Burden (Hours)	21,266,302	21,266,302	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $274,020,946

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/19/2025

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