Public Payers News

Medicaid, CHIP Enrollment Increased After 2 Years of Decline

The increase in Medicaid and CHIP enrollment was largely due to the economic and regulatory impacts of the coronavirus and impacted Medicaid enrollment more than CHIP.

Medicaid, CHIP, coronavirus

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By Kelsey Waddill

- Medicaid and Children’s Health Insurance Program (CHIP) enrollment increased through November 2020, as anticipated, Kaiser Family Foundation data note.

“Increases in enrollment reflect changes in the economy (as more people experience income and job loss and become eligible and enroll in Medicaid and CHIP coverage) and provisions in the Families First Coronavirus Response Act (FFCRA) that require states to ensure continuous coverage to current Medicaid and CHIP enrollees to access a temporary increase in the Medicaid/CHIP match rates,” the data note explained.

The data showed that experts’ original projections were not too far from the truth, culminating in an increase of slightly more than 10 percent for combined Medicaid and CHIP enrollment in October 2020.

Actual data, as opposed to projected data, showed the Medicaid and CHIP combined enrollment from February 2020 to October 2020 reached 7.2 million. Using preliminary data, experts anticipate that in November 2020 that number rose half a million to hit 7.7 million enrollees.

The projected trajectory had been that enrollment would add 2.9 million more enrollees in May 2020 and that enrollment would continue to grow from May through November 2020. The experts expected Medicaid and CHIP enrollment to reach 8.3 million individuals by November 2020.

This data, both preliminary and actual, represents a reversal in the Medicaid and CHIP enrollment trends. In 2017, the number of uninsured children rose to five percent and coincided with a 2.2 percent decline in children’s enrollment in CHIP and Medicaid in 2018.

CHIP enrollment had declined to a record low of 4.7 percent the year prior and in spite of a strong economy. Experts blamed the partial repeal of the Affordable Care Act among other factors.

From December 2017 to 2019, Medicaid and CHIP enrollment fell 3.1 percent, KFF researchers stated in the recent data note.

Most of the growth that occurred from February 2020 to November 2020 happened in the Medicaid space. Medicaid saw 11.8 percent enrollment growth while CHIP enrollment only rose by 1.5 percent overall.

Among adults more specifically, growth in overall Medicaid and CHIP enrollment reached 14.1 percent during the data note’s timeframe. While the economy and regulatory changes played a role, the researchers also pointed to Medicaid expansion in three states as boosting enrollment overall.

Looking to the future, the researchers anticipated that enrollment in Medicaid and CHIP might continue its incline.

“There is usually a lag between unemployment and Medicaid enrollment growth, so even if unemployment starts to decline, there may continue to be Medicaid enrollment growth,” the data note explained.

“Current enrollees will not be disenrolled due to the maintenance of eligibility (MOE) that will remain in place during the public health emergency period. Additionally, the ACA open enrollment period could also increase Medicaid/CHIP enrollment in future enrollment reports.”

The federal health insurance marketplace’s special enrollment period could also have an impact on Medicaid and CHIP enrollment. The federal platform, HealthCare.gov, provides a consolidated marketplace for the Affordable Care Act’s federal marketplace plans as well as Medicaid and CHIP enrollment options.

“Medicaid/CHIP enrollment reports are lagged by approximately four months, but future data will provide better insight into how national and state-by-state Medicaid enrollment is responding to the pandemic, economic recovery efforts as well as the ACA open enrollment period,” the data note mentioned.

Previously, data showed that Medicaid managed care organization enrollment was still rising through September 2020.

Within the first few months of the initial coronavirus outbreak in the US, it was clear to KFF experts that Medicaid spending and enrollment would surpass their original projections for 2020.

Of the 38 states that participated in the May 2020 KFF survey, 32 states’ officials reported that negative economic environment and the maintenance of eligibility standards would lead to higher Medicaid enrollment in 2020.