ACA-Enabled Medicaid/CHIP Estimates now stand at 3.65M or 4.91M

OK, to repeat: The January CMS Medicaid/CHIP Report has finally been released:

According to a new CMS report released today, between October and January, more than 8.9 million individuals were determined eligible for Medicaid or CHIP through state agencies and through state-based Marketplaces. More than 2 million people were informed in January that they are eligible for Medicaid and the Children’s Health Insurance Program (CHIP); more of those individuals are in states that have chosen to expand Medicaid coverage to more of their residents.

These numbers include both Medicaid and CHIP new eligibility determinations in states that expanded coverage; determinations made based on laws that predate the Affordable Care Act and for groups not affected by the health care law; and in some states, Medicaid renewals. These numbers do not include Medicaid eligibility determinations made through the Federally-Facilitated Marketplaces (HealthCare.gov).  Today’s report is the fourth in a series of monthly reports on state Medicaid and CHIP data. We anticipate reporting on Medicaid and CHIP enrollment in future months.

The 8.9M total includes all 4 months (Oct, Nov, Dec and Jan); the January-only total is around 2.44 million enrollees.

Again, some crucial things to remember about what the 2.44 million figure does and doesn't include:

  • It does include state-based exchange enrollments.
  • it does NOT include federal exchange enrollments.
  • it does include non-exchange state agencies (traditional enrollments)
  • it does include expansion in states that went with it.
  • it does include woodworkers in all states.
  • it does include redeterminations (renewals)...but only in SOME states.

I've had a chance to go through the report, plug the January numbers into the Medicaid Spreadsheet, and then either eliminate, reduce or even increase the number (due to it being a count of households instead of individuals for that state), depending on the footnotes in the report.

As I've done with the prior reports, I've had to eliminate the CMS data from 11 states (+DC) entirely because those states insist on mixing in redeterminations (renewals) with the new enrollees. Since there's no way of separating them out, I've had to delete these completely. These include DC, IA, MA, MI, NV, ND, NM, SD, TX, UT, VA and WY.

A 13th state, Missouri, includes renewals for CHIP enrollments but doesn't include them for Medicaid (don't ask me why the do it for one but not the other), while a 14th state, Rhode Island, does the reverse--they included renewals for Medicaid but not for CHIP (!!!!!)

Between this and the othe reductions (mostly removing duplicated data which HHS already reported in their report), the actual starting number has dropped from 2.44 million down to 1.57 million. From there, it inches up a smidge due to 5 states (AK, CT, NV, NC and OR) counting households instead of people (although Nevada doesn't get counted at all, since they're one of the states which mixed in renewals).

Add all of these to the mix and the grand totals come out as follows, based on my revised model from earlier this week:

  • Legal ACA Expansion ONLY: 3.65 Million (up from 3.27 Million)

  • Expansion + Woodworkers: 4.91 Million (up from 4.29 Million)

(Whoops...forgot about the 53,000 Connecticut enrollees from the Jan HHS exchange report which weren't included in the CMS number for whatever reason...strange, since Oct/Nov/Dec all were included, but whatever...this bumps the numbers up by about 20K and 30K respectively from my initial Tweet...)