Public Payers News

156M Beneficiaries Receive Health Insurance Through Public Programs

As of September 2022, public programs provide health insurance coverage to 156 million beneficiaries, including 65.1 million people who are enrolled in Medicare and 90.9 million people who are enrolled in Medicaid and CHIP.

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Source: Getty Images

By Victoria Bailey

- More than 150 million people receive health insurance through public programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), according to the latest enrollment data from CMS.

The data reflects enrollment in the programs as of September 2022.

Over 65 million people are enrolled in Medicare, indicating an increase of 160,823 beneficiaries from the last report, CMS said. Nearly 35 million beneficiaries are enrolled in fee-for-service Medicare, while 30.1 million are enrolled in Medicare Advantage plans, with and without prescription drug coverage.

Among the 65 million beneficiaries, over 50.5 million are enrolled in Medicare Part D, including standalone prescription drug plans and Medicare Advantage plans offering prescription drug coverage.

As of September, 90.9 million people are enrolled in Medicaid and CHIP. A total of 83.9 million beneficiaries are enrolled in Medicaid and around 7 million receive health insurance coverage from CHIP. Medicaid enrollment has increased by 390,277 beneficiaries from August, while CHIP enrollment decreased by 24,225 individuals.

Since February 2020, Medicaid and CHIP enrollment has grown by 28.6 percent or 20.2 million beneficiaries. Medicaid enrollment increased by 19.9 million individuals (31.2 percent) and CHIP enrollment rose by 293,986 beneficiaries (4.4 percent).

These increases likely resulted from the COVID-19 pandemic and the accompanying continuous enrollment policies in the Families First Coronavirus Response Act.

As of September, more than 12 million beneficiaries are dually eligible for Medicare and Medicaid and were counted in the enrollment figures for both of the programs.

Medicare Advantage beneficiaries accounted for almost half of all Medicare beneficiaries. The success of the private program has played a significant role in Medicare enrollment growth.

According to data from June 2022, Medicare Advantage plans accounted for 50 percent or more of Medicare enrollment in 123 congressional districts and over 30 states had more than 40 percent of Medicare beneficiaries covered by Medicare Advantage plans.

Medicare Advantage enrollment soared in 2022, with beneficiaries reporting high satisfaction rates and low spending.

For Medicaid and CHIP, the pandemic played a significant role in boosting enrollment in the public programs, but 18 million people may lose Medicaid coverage once the public health emergency (PHE) ends. After the PHE ends, states must resume coverage redeterminations. If states begin rapid disenrollment, around 5 million people could lose Medicaid in the first month after redeterminations occur.

In particular, many states expect seniors and people with disabilities to lose Medicaid coverage when the PHE expires. According to the Kaiser Family Foundation, streamlining eligibility and enrollment processes could help minimize these coverage losses.