View Information Collection Request (ICR) Package
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View ICR - Agency Submission
COMMENT
Time Remaining
Days
HR
Min
Sec
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
Requested
Previously Approved
Expiration Date
36 Months From Approved
01/31/2026
Responses
76,500,218
76,500,218
Time Burden (Hours)
21,266,302
21,266,302
Cost Burden (Dollars)
0
0
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.
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
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
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
Number of Information Collection (IC) in this ICR:
4
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)
ICR Summary 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:
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
Agency Contact:
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
Common Form ICR:
No
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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