January Medicaid Report is out: Net increase of 12.2M via ACA (lowering my estimate)

Hmmm...looks like I overshot the mark a bit this time around, but still impressive growth in Medicaid/CHIP enrollment:

From the report:

  • The 51 states (including the District of Columbia) that provided enrollment data for January 2015 reported nearly 70 million individuals were enrolled in Medicaid and CHIP.6 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.
  • 394,023 additional people were enrolled in January 2015 as compared to December 2014 in the 51 states that reported comparable January 2015 and December 2014 data.7

(And yes, the "51 states" wording is CMS's, not mine)

  • Looking at the additional enrollment since October 2013 when the initial Marketplace open enrollment period began, among the 49 states reporting both January 2015 enrollment data and data from July-September of 2013, approximately 11.2 million additional individuals are enrolled in Medicaid and CHIP as of January 2015, nearly a 19.3 percent increase over the average monthly enrollment for July through September of 2013.8 (Connecticut and Maine are not included in this count.)

  • Among states that had implemented the Medicaid expansion and were covering newly eligible adults in January 2015, Medicaid and CHIP enrollment rose by over 26.1 percent compared to the July-September 2013 baseline period, while states that have not, to date, expanded Medicaid reported an increase of over 7.8 percent over the same period.

  • Twelve of the 27 states that had implemented the Medicaid expansion and were covering newly eligible adults in January 2015, and that reported relevant data for both January and the JulySeptember 2013 baseline period, experienced an enrollment increase of 30 percent or more. 11 

OK, so that's a net increase of 11.2 million through 1/31/15. 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.

If you add those 950K in, the total net increase in Medicaid/CHIP enrollment due to the Affordable Care Act is closer to 12.2 million through the end of January.

If you look at the Medicaid Graph, however, I estimated about 13.0 million even at the end of January; apparently I overshot the mark by a good 800K.

It looks like I made a bit of a mistake at the beginning of January. I figured there'd be a one-time spike in enrollments (obvious on the Graph), but what I forgot about is that a lot of 2014 Medicaid enrollees may not have renewed their enrollments yet (unlike the private exchanges, there's no auto-renewals for Medicaid as far as I know). Plus, of course, the improvement in the economy may mean fewer people need Medicaid, which certainly isn't a bad thing!

Anyway, with the addition of Pennsylvania and Indiana to the ACA expansion list (even if Indiana is doing it in a confusing-as-hell, complicated manner), the numbers should continue to rise throughout the year...albeit at a slower pace, as the other expansion states basically max out their Medicaid expansion pools.

That being the case, I'm going to have to revise the Medicaid Graph, knocking 800K off of the 1/31 total as well as likely reducing the rate for February as well (I've already "slowed down" my projection rate for March). Based on that, it looks like the current net Medicaid/CHIP increase due specificially/in large part to the ACA is more like 12.8 million as of today, vs. the 14.1 million I've been thinking until now.