2018 MIDTERM ELECTION

Time: D H M S

The September Medicaid Report is out: Net increase of 9.1M + 950K via ACA

  • The 51 states (including the District of Columbia) that provided enrollment data for September 2014 reported nearly 68 million individuals were enrolled in Medicaid and CHIP. This enrollment count is point-in-time (on the last day of the month) and includes all enrollees in the Medicaid and CHIP programs who are receiving a comprehensive benefit package.
  • 340,159 additional people were enrolled in September 2014 as compared to August 2014 in the 51 states that reported comparable September and August data.
  • Looking at the additional enrollment since October 2013 when the initial Marketplace open enrollment period began, among the 49 states reporting both September 2014 enrollment data and data from July-September of 2013, over 9.1 million additional individuals are enrolled in Medicaid and CHIP, approximately a 16 percent increase over the average monthly enrollment for July through September of 2013. (Connecticut and Maine are not included in this count.)
  • Among states that had implemented the Medicaid expansion and were covering newly eligible adults in September 2014, Medicaid and CHIP enrollment rose by approximately 23 percent compared to the July-September 2013 baseline period, while states that have not, to date, expanded Medicaid reported an increase of over 6 percent over the same period.
  • Ten of the 25 states that had implemented the Medicaid expansion and were covering newly eligible adults in September 2014, and that reported relevant data for both September and the July-September 2013 baseline period, experienced an enrollment increase of 30 percent or more.

OK, so that's 9.1 million through 9/30/14. However, as I noted when I reported on the August report, this doesn't include...

These enrollment counts are in addition to the enrollment increases from the nearly 950,000 individuals who gained coverage as a result of the Affordable Care Act before open enrollment began. Seven states implemented an “early option” to expand Medicaid coverage to adults with incomes up to 133 percent of the FPL between April 1, 2010 and January 1, 2014, using new state plan authority provided by the Affordable Care Act or a demonstration under section 1115 of the Social Security Act building upon that authority.

Again, I have this number being a bit higher (1.2 million), but it basically includes transferees from California's LIHP program, which temporarily moved 650,000 residents into a sort of "holding plan" thanks to provisions in the ACA which allowed them to do so in preparation for the official Medicaid expansion,which didn't start until January 2014. I include these folks on both the Medicaid spreadsheet and The Graph (under the "Bulk Transfer" heading).

So, if you add 9.1 million + 950,000, you get a net increase of 10.05 million on Medicaid/CHIP through 9/30/14.

How does this match up with my estimates? As usual, my estimate for that time period is a bit higher: About 10.5 million, or 450K higher, meaning I overshot by about 4.5%. I don't feel too bad about that, though, since Medicaid churn is a royal PITA to work with.

Over half of that (250K) is the "bulk transfer" discrepancy; I'll have to look into that one of these days...

Anyway, for the record, I have the current (ie, mid-November) net Medicaid/CHIP increase down as being around 11.4 million; if I turn out to be overshooting by a similar 4.5%, that means the actual number will probably end up only being 10.9 million, but we won't know that until mid-January...