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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Medicaid and CHIP Enrollment Climbs by 6M vs. Pre-Health Reform Era

June 11, 2014 | Medicaid | Comments
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Newly released data from the Centers for Medicare & Medicaid Services (CMS) indicate that Medicaid enrollment continued to grow throughout April, beyond the March 31 end of the open enrollment period in state and federal health insurance exchanges. Because enrollment in Medicaid and the Children’s Health Insurance Proram (CHIP) can occur year-round, enrollment under the programs continues to grow. The new data show roughly six million more Medicaid and CHIP enrollees as compared to the period immediately preceding the initial open enrollment period under the Affordable Care Act (ACA).

Highlights of the report include:

  • Total Medicaid and CHIP Enrollment is Rising Compared to Pre-ACA. According to the latest data, over 65 million individuals were enrolled in Medicaid and CHIP during the month of April (across the 48 states plus D.C. that reported data) – or roughly 1.1 million additional individuals when compared to March enrollment data. When taking a more retrospective look at enrollment trends under these programs, CMS notes that Medicaid and CHIP enrollment grew by 6 million additional individuals – a 10.3% increase – as compared to the average monthly enrollment over the July-September 2013 period that preceded the initial ACA open enrollment that began last October.
  • Enrollment in “Expansion States” Rose Most, but Non-Expansion States Also Saw Increases. CMS notes that, “[a]mong states the adopted the Medicaid expansion and whose expansions were in effect in April 2014, Medicaid and CHIP enrollment rose by 15.3[%] compared to the July-September 2013 baseline period, while states that have not, to date, expanded Medicaid reported a 3.3[%] increase over the same period.” CMS goes on to note that 9 of the 24 Medicaid expansion states (in effect as of April 2014) reported enrollment increases of over 25%, namely: Colorado, Kentucky, Maryland, Nevada, Oregon, Rhode Island, Vermont, Washington, and West Virginia.
  • Consumers are Submitting Applications for Financial Assistance. During the month of April, state Medicaid and CHIP agencies received roughly 2.4 million total applications for financial assistance (which, as the agency notes, includes Medicaid and CHIP coverage, tax credits and subsidies). CMS notes that, “[w]hen applications received by [State-based Marketplaces] SBMs are included, total applications for coverage and financial assistance submitted at the state level reached 3.5 million (including 2.4 received directly by state Medicaid and CHIP agencies and approximately 1.1 million received by SBMs).”
  • States are Using “Administrative Transfer” Enrollment Method. As per guidance released by CMS in May 2013, five states (as of last April) began to implement an optional new tool to help facilitate Medicaid and CHIP enrollment and renewal via an “administrative transfer” method. Through this process, these five states – Arkansas, California, Illinois, Oregon, and West Virginia –  use eligibility information from the Supplemental Nutrition Assistance Program (SNAP) to identify individuals potentially eligible for Medicaid and CHIP. As discussed in more detail on p. 8 of the report, the five states implementing this strategy determined 557,040 individuals eligible for Medicaid or CHIP through the administrative transfer enrollment method – an increase of 43,278 compared to the former month.