Medicaid as First Responder: Enrollment Is on the Rise

Key Findings

  • An analysis of administrative data from 21 states finds that total Medicaid enrollment increased by 2.8 percent from February to April of 2020. For a subset of these states (14) it is possible to look at children’s enrollment, which has seen similar growth (2.6 percent) across the examined states.
  • Of the examined states, those with the largest increases in total enrollment are: Missouri (6.5 percent), Florida, Indiana, and Wisconsin (all 5.1 percent). Montana was the only state showing a decline in Medicaid enrollment.
  • Medicaid enrollment is highly sensitive to changes in unemployment rates; of those losing their employer sponsored health insurance, national studies project that Medicaid will be the most important source of public coverage for those losing employer sponsored insurance, with nearly half projected to be eligible and/or enroll.


Medicaid is and will continue to play a central role in the nation’s response to the COVID-19 pandemic with respect to both the health crisis and the ensuing economic crisis. With unemployment rapidly rising to double digits and workers (and their spouses and dependent children) losing their employer-sponsored insurance, it has been widely expected that Medicaid/CHIP enrollment would increase. Medicaid enrollment has long been closely aligned with the unemployment rate. Since national enrollment data for the same time period won’t be available until July, we examined publicly available state administrative data from 21 states.

March data did not yet show any clear signs of an enrollment surge despite the required freeze on disenrollment included in the Families First Coronavirus Response Act, which took effect on March 18th. April data, however, tell a different story.

Full Report

Read the full report here.

Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy.