Good News/Bad News re. Medicaid Enrollment Analysis

I have some good news and some bad news regarding my recent exclusive analysis of the ACA Medicaid/CHIP enrollment numbers.

The good news is that there are now 3 states (Washington, Colorado and Maryland) which have started breaking out Medicaid renewals from new enrollments (well, Washington lists them separately; Colorado doesn't include renewals in their report at all, and Maryland appears to be "backing out" prior numbers to separate renewals out from new enrollments).

What this means is that for at least 3 out of 51 state exchanges (including DC), the Medicaid numbers going forward should reflect "true" ACA enrollments instead of mixing together renewals.

Furthermore, Colorado's official report specifically states that it includes all new Medicaid enrollments, not just via the exchange but direct ones as well, in a single report. This means no guessing about whether Colorado's numbers are being double-counted or if they overlap; that 101,730 Colorado Medicaid enrollment figure from 2 days ago is THE Medicaid number to use, period:

PEAK metrics include and referrals from Connect for Health Colorado’s website. In January, there was approximately a 47/53 percent split between applications through and referrals.

**These are new applications for Medicaid or Child Health Plan Plus (CHP+) and do not include redeterminations. An application can include multiple individuals

(another bonus bit of good news: note that the Colorado report also specifies that these applications are for households, not individuals, so the true number of people could be 2-3x higher)

The bad news is that for the other 49 states (+DC), sorting out the individual state numbers as laid out above in any sort of coherent way on the spreadsheet itself would simply be too damned confusing for anyone to be able to follow.

I had planned on doing this tonight, but after several hours of experimenting with extra rows, extra columns and so on, it's just too Herculean a task to pull off without making the entire spreadsheet an indecipherable mess.

So, until further notice, I'm going to have to backtrack on my "update the spreadsheet with the new numbers" statement mentioned a few days back and leave things pretty much as they are, at roughly 4.5 million. I trust the topline number (roughly 6.4 million ACA Medicaid/CHIP enrollments), but the state-by-state breakdown figures are just too shaky for me to be confident in publishing publicly.

Hopefully HHS or CMS will sort this out (and soon) with a new report that clearly and distinctly updates and breaks down the data for each state into:

  • Exchange-based (new) Medicaid/CHIP enrollments
  • Direct (new) Medicaid/CHIP enrollments
  • Special/One-Time Bulk Transfers from existing state-level healthcare programs
  • Any other categories

Until they do so, however, I'll have to keep my own updated breakdown on the back burner.