Medicaid Enrollment Jumps 3 Million

Participation in the federal program as of February is higher than pre-Obamacare totals, but we still don’t know what portion are newly eligible under the health law.

SAN FRANCISCO, CA - SEPTEMBER 21: Protestors carry signs as they demonstrate against proposed cuts to Medical and Medicare outside San Francisco city hall on September 21, 2011 in San Francisco, California. Dozens of disabled people staged a protest against proposed cuts to Medical, Medicare and Medicaid programs.
National Journal
Sophie Novack
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Sophie Novack
April 4, 2014, 8:30 a.m.

Three mil­lion ad­di­tion­al people have en­rolled in Medi­caid cov­er­age as of the end of Feb­ru­ary, com­pared with pre-Obama­care fig­ures, the Cen­ters for Medi­care and Medi­caid Ser­vices an­nounced Fri­day.

The re­port finds that as of the end of the fifth month of open en­roll­ment un­der the Af­ford­able Care Act, 3 mil­lion more people are en­rolled in Medi­caid and CHIP pro­grams, com­pared with the av­er­age total en­rolled between Ju­ly and Septem­ber of last year. The data is from the 46 states re­port­ing their en­roll­ment in Feb­ru­ary and be­fore Oc­to­ber, and does not in­clude March.

Medi­caid en­roll­ment has in­creased by ap­prox­im­ately 633,170 between Janu­ary and Feb­ru­ary of this year.

As of the last day in Feb­ru­ary, about 62.3 mil­lion in­di­vidu­als were en­rolled in Medi­caid and CHIP in the 48 states re­port­ing en­roll­ment in­form­a­tion — more than 20 per­cent of the U.S. pop­u­la­tion.

The White House an­nounced earli­er this week that 7.1 mil­lion Amer­ic­ans have en­rolled in private cov­er­age through the in­sur­ance ex­changes. An ad­di­tion­al 3 mil­lion young adults were covered un­der their par­ents’ in­sur­ance, ac­cord­ing to the ad­min­is­tra­tion.

The health law calls for an ex­pan­sion of Medi­caid to all adults up to 138 per­cent of the fed­er­al poverty level. However, a 2012 Su­preme Court rul­ing made that op­tion­al for the states; cur­rently 26 states plus the Dis­trict of Columbia are ex­pand­ing Medi­caid, 19 are not, and five re­main un­de­cided.

The de­cision to ex­pand Medi­caid has had a dra­mat­ic im­pact on the num­ber of in­di­vidu­als en­rolled in the fed­er­al pro­gram over the past five months. Ac­cord­ing to the CMS re­port, in states that are par­ti­cip­at­ing in ex­pan­sion — and where ex­pan­sion was already in ef­fect in Feb­ru­ary — en­roll­ment in­creased by 8.3 per­cent com­pared with the months pri­or to ACA open en­roll­ment be­gin­ning Oct 1. States that have not ex­pan­ded Medi­caid cov­er­age re­por­ted a 1.6 per­cent in­crease.

The en­roll­ment num­bers are dif­fer­ent from Medi­caid eli­gib­il­ity de­term­in­a­tions in that they in­clude those who left as well as entered the Medi­caid pro­gram, and they do not in­clude those who are simply re­new­ing cov­er­age.

CMS says that 11.7 mil­lion people have been de­term­ined eli­gible for Medi­caid and CHIP between Oct. 2013 and Feb. 2014, but this total in­cludes any­one who has ap­plied for cov­er­age in that peri­od and been deemed with­in the re­quire­ments.

However, a few ques­tions re­main. CMS has not pre­vi­ously asked states to re­port this in­form­a­tion, so com­par­at­ive data on how much en­roll­ment fluc­tu­ated pri­or to the ACA are not avail­able. And we still do not know how many of those en­rolled in Medi­caid cov­er­age are newly eli­gible un­der the health care law.

These num­bers will con­tin­ue to grow; Medi­caid en­roll­ment is not part of the des­ig­nated open en­roll­ment peri­od, but is avail­able year-round.

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