CMS Reports Medicaid Enrollment Gains of 3 Million (and counting)

After hearing that more than 7 million people were enrolled through the marketplaces before the close of open enrollment on March 31st, we’ve been anxiously awaiting the release of companion Medicaid and CHIP enrollment data.

The wait is over!

CMS has released monthly eligibility and enrollment activity data since October 2013, but the hot-off-the-press February report goes further. Prior reports focused on key processes: the number of applications submitted and the number of eligibility determinations. But with renewal activity included in those numbers for some states, it was difficult to tease out the impact on overall enrollment. This month’s report gives a clearer sense of enrollment gains:

  • Medicaid and CHIP enrollment is up 3 million or an average of 5.2% in the 46 states that previously reported baseline data for comparison.
  • In states that expanded Medicaid and have implemented the expansion, enrollment was up an average of 8.3%.
  • Enrollment gains exceeded 10% in 12 expansion states, with Oregon, Vermont, and West Virginia leading with impressive gains of 32% – 35%, and Colorado, Maryland, Nevada, and Washington coming in with gains of more than 20%. Notably, all of these states have either state-based or partnership exchanges, where outreach and consumer assistance have been more abundant.
  • Non-expansion states experienced only a modest enrollment gain of 1.6%. On the downside, Alaska, Alabama, Louisiana, Nebraska, South Dakota, Texas and Wisconsin saw Medicaid/CHIP enrollment shrink by .4% – 7.2%.

Notably, a fast-track enrollment strategy, using SNAP data to identify and enroll people who are eligible for Medicaid, has helped connect nearly half a million (453,083) people with coverage. This strategy not only streamlines the process but can save administrative costs for processing individual applications.

February enrollment data likely understates Medicaid and CHIP enrollment because not all states reported data and there are still a number of account transfers in process between HealthCare.Gov and state Medicaid/CHIP agencies. But it’s also important to note that these data are preliminary. And more importantly, although common data elements must be reported, states are still transforming their reporting capacity to conform to standardized data definitions. As states shift to their new eligibility and enrollment systems, further improvements in the quality of the data and our ability to draw conclusions from it can be expected.

Tricia Brooks is a Research Professor at the Center for Children and Families (CCF), part of the McCourt School of Public Policy at Georgetown University.