Medicaid & CHIP enrollment update

Reports

Observations based on analysis of Medicaid/CHIP enrollment estimates through December 2014.

On February 23, 2015, the Department of Health and Human Services publicly released preliminary estimates of Medicaid/CHIP enrollment through the month of December 2014.

According to preliminary estimates, Medicaid / CHIP enrollment increased 25.2% (9.3M) in expansion states and 7.8% (1.7M) in non-expansion states by December 2014, relative to 3-month pre-ACA baseline. 27 expansion states and DC, as well as 20 non-expansion states, reported a cumulative increase in enrollment (as of December 2014) relative to baseline. In the expansion states that had not provided full coverage for childless adults before ACA enactment, enrollment increased 27.9% over baseline, compared with 12.7% in states with pre-ACA full coverage for childless adults. The total increase in enrollment through December 2014 surpassed 2014 estimates and is ~50% of 2016 monthly enrollment projections. Data indicate that Medicaid / CHIP enrollment growth continued through 2014.

In the first month of the 2015 open enrollment period (11/15/14 – 12/15/14), approximately half a million individuals were found to be eligible for Medicaid after applying for coverage through the FFM in the 37 states using that Marketplace. Nationally, this represents 9% of total applicants to the FFM. Medicaid enrollments resulting from these applications do not yet show up in the December 2014 totals.

The proportion of FFM applicants found to be eligible for Medicaid varied dramatically across the states, from a low of 3% in Montana and Texas to a high of 21% in Nevada. As expected given the higher Medicaid threshold in expansion states, 12 of the 14 states with above-average rates of Medicaid eligibility determinations among those applying through the Marketplace had expanded Medicaid, while 18 of 19 states with below-average eligibility determination rates had not expanded Medicaid. It is possible that a state's expansion status affects the number of low-income families that apply for Medicaid through the Marketplace (this issue may be a target of future analysis).

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