CCF’s Unwinding and Enrollment Trackers Explained

Since Medicaid unwinding of the continuous coverage requirement has begun, net child Medicaid enrollment has fallen by more than two million and overall net Medicaid enrollment has declined by more than five million.  We have received some questions about how we calculate these net enrollment figures as well as the basis of other unwinding data we have posted, including state-specific renewal outcomes such as procedural terminations and ex parte renewals.

CCF posts its unwinding data here, which is frequently updated.  Here’s an explanation of each CCF unwinding data tracker:

  1. Impact of Unwinding on Medicaid Enrollment

Entitled “What is the impact of unwinding on Medicaid enrollment?,” our primary Medicaid unwinding enrollment tracker shows national and state-by-state overall Medicaid enrollment and Medicaid child enrollment by month, with the first month being when unwinding terminations in the state commenced.

This tracker uses the most recent monthly data available, which will vary by state.  In 31 states, the data source is state administrative data and in 20 states (including the District of Columbia) for which state administrative data is not available, the data source is preliminary monthly enrollment data reported by the Centers for Medicare and Medicaid Services (CMS).  The data sources used for each state are listed here.

In addition, this tracker includes an interactive state-by-state “heat” map showing the number and percentage decline in overall net Medicaid enrollment and in net Medicaid child enrollment in the most recent month for which data is available, relative to the first month of unwinding terminations.  Note that net declines in enrollment are driven by several factors that move in different directions.  This includes, for example, unwinding disenrollments partially offset by enrollment increases due to new applications and reinstatements/reenrollments of those previously terminated from Medicaid coverage.

All data used in this tracker are available in this downloadable spreadsheet.

  1. Impact of Unwinding on Net Medicaid Child Enrollment

Entitled “How many children are losing Medicaid?,” our net Medicaid child enrollment tracker shows the national aggregate decline in net Medicaid enrollment among children since unwinding began.  The data is the same used for the primary Medicaid unwinding enrollment tracker.

  1. Medicaid Renewal Outcomes by State

Entitled “What is happening with Medicaid renewals in each state?,” our renewal outcome tracker includes an interactive state-specific chart of unwinding renewal outcomes. The tracker includes (1) outcomes — ex parte renewal, renewal based on renewal form, determination of ineligibility or procedural disenrollment — for all renewals due; (2) outcomes only for renewals that have been completed (i.e., excluding pending renewals); and (3) disenrollment outcomes — a determination of ineligibility or procedural disenrollment — as a share of total disenrollments. This tracker uses the monthly Medicaid renewal outcome data that states are required to report to CMS.  However, 25 states publicly post the data they report to CMS or otherwise make it available before CMS releases its renewal outcome data for all states each month.  In that case, the tracker uses the most recent data available from states, rather than relying on the CMS monthly release. In the situation where there are discrepancies between what states post and what CMS includes in its monthly release of reported data, the tracker uses the CMS reported data. Links to the data used in this tracker are available in this downloadable spreadsheet.

  1. Other State Unwinding Information and Data

Finally, CCF continues to collect additional information related to unwinding.  Entitled “Medicaid Unwinding, Federal Reporting, Strategies/Policies and Data by State,” this page and accompanying detailed spreadsheet includes detailed information and links related to state unwinding policies, documents, and information. This includes, for example, the state’s original proposed plan for the unwinding, the communication tools being used and other unwinding data being posted by states through “state dashboards” that may include more detailed, disaggregated data on unwinding renewal outcomes.