June CMS Report: Net increase of 7.2 Million enrolled since Oct. 2013 (+ 950K pre-Oct)

OK, I still have to plug the numbers into the spreadsheet, but here's the major takeaways:

• Across the 49 states (including the District of Columbia) that provided enrollment data for June 2014, states reported that approximately 66 million individuals were enrolled in Medicaid and CHIP. [actual: 66,112,314]

• 602,210 additional people were enrolled in June 2014 as compared to May 2014 in the 49 states that reported both June and May data.

• ...approximately 7.2 million additional individuals are enrolled in Medicaid and CHIP, a 12.4 percent increase over the average monthly enrollment for July through September of 2013.

• Among states that adopted the Medicaid expansion and whose expansions were in effect in June 2014, Medicaid and CHIP enrollment rose by over 18.5 percent compared to the July- September 2013 baseline period, while states that have not, to date, expanded Medicaid reported an increase of approximately 4 percent over the same period.

• 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 Section 1115 demonstration building upon that authority.

Most of the points above aren't particularly surprising or noteworthy (at least to me). The last point, however, is HUGE from my perspective.

As regular ACA Signups followers know, there's always been a significant gap between my estimate of the number of new Medicaid/CHIP enrollees and the actual number reported by CMS in their monthly reports. For instance, at the moment, I have it down as around 10.3 million vs. the 7.2 million that CMS just reported.

Part of this, of course, is that the CMS reports are always a month or more behind my data. The May report didn't come out until mid-July, and this June report is coming out in early August. If July was similar to June, that likely accounts for around 600K of the difference.

As for the remaining 2.5 million, until now I've always chalked this up to a combination of processing backlogs (a whopping 600K in California alone), rounding errors and misestimates on my part for one state or another.

However, it now appears that 950,000 of this difference can be chalked up to CMS not including the bulk transfers which took place prior to January 1st! This includes, for instance, the 650,000 enrollees in California's LIHP program and similar "auto-transfers" from as early as July 2012.

I have all 950K of these folks--along with another 240,000 other "bulk transfers" since the beginning of the year--listed on both the Medicaid spreadsheet and The Graph (the 1.19 million section), but I didn't notice the specific reference to this in the monthly CMS reports until now.

That leaves roughly 1.5 million in backlogs/etc. Since California alone accounts for 600K of these, it's reasonable to assume another 950K or so spread out among the other 49 states & DC. Voila! Mystery solved!

So, in short:

• ACA Medicaid/CHIP expansion, 4/10 - 9/13: 950K
• ACA Medicaid/CHIP expansion, 10/13 - 6/14: 7.2M
• ACA Medicaid/CHIP expansion, 7/14: 600K (est.)
• Backlogged Enrollments, CA: 600K
• Backlogged Enrollments, Other: 950K

However, this does bring up another issue: I should really subtract those 1.55 million backlogged folks from the Graph for now.

UPDATE: Done. Both the spreadsheet and the Graph now reflect the subtraction of 1.55M in backlogged enrollments (at the bottom of the spreadsheet). This knocks the grand total range down by 1 million overall (from 24-29M down to 23-28M).