The May CMS Medicaid/CHIP Report is Out: Net gain of 6.7M since Oct. 2013 (UPDATED)

OK, I just received the report itself, so it'll take awhile to slog through the numbers, but here's the chief takeaways:

Medicaid enrollment continues to increase all across the country, especially in those states that have expanded their Medicaid programs under the Affordable Care Act.

As of the end of May, 6.7 million more individuals were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) as compared to the baseline period from July through September 2013, an increase of 11.4 percent. That includes more than 920,000 additional people enrolled in May as compared to April in the 48 states and the District of Columbia that reported data.

As we’ve seen for months, growth was more pronounced in 26 states (including the District of Columbia) that had adopted and implemented the Medicaid expansion by the end of May.  Enrollment in those states rose by 17 percent, while states that have not expanded reported only a 3 percent increase.

So, the net enrollment gain as of May 31st was 700K higher than it was as of April 30. The 220K difference between this and the 920K "additional people" is presumably due to baseline churn (ie, people who were on Medicaid/CHIP moving off of it for one reason or another...hopefully due to their situations improving, although obviously dying would take them off the tally as well...)

So, what accounts for the difference between CMS's 6.7 million net increase (actually 6.65 million, according to page 13 of the report) and my own 9.6 million estimate? Well, according to the recent Urban Institute report which I reported on yesterday, as of the end of June there were around 2.9 million pending Medicaid/CHIP enrollment applications. Add those to the 6.7 million figure and you get...9.6 million.

Obviously these numbers don't jibe precisely; the CMS number only runs through 5/30; it's missing all of June and the first week of July. Furthermore, my own data includes some amount of estimates for some states. Still, this is the third piece of hard data in the past few days which has strengthened my confidence in my 9.6 million estimate.

UPDATE: OK, I've plugged the actual numbers into the Medicaid spreadsheet, deleted the usual "renewals/redetermination" states and other oddball footnotes/caveats in the report. I've also added a new step to my estimates: I'm assuming 95% of those determined eligible for Medicaid/CHIP actually enroll in the programs (this is something which I previously assumed everyone who got to this point would do, but apparently not). WIth all of this, I now have the following updated estimates:

  • Strict Expansion: 5.98 Million (up from 5.85 Million)
  • Bulk Transfers: 1.19 Million (unchanged)
  • Woodworkers: 2.76 Million (up from 2.52 Million)

...for an overall net increase from 9.56 Million up to 9.93 Million (net gain of about 370,000).

Again, as noted above, the bulk of the difference between my 9.93 Million and the CMS Dept's 6.65 Million appears to be the 2.9 million "pending" applications of people who have been "determined eligible" but not actually enrolled yet. The remaining 380,000 are presumably a combination of June additions and general churn.