October CMS Medicaid Report: Net increase of 13.5M (actually 14.5M)

I somehow managed to completely miss the September Medicaid report released last month, but it turned out to be a virtual non-issue; there was a net increase of just 2,599 people enrolled in Medicaid nationally from the end of August through the end of September 2015.

In October, however, things picked up; while not nearly the half-million-plus-per-month that we saw during 2014 and the first half of this year as the bulk of ACA Medicaid expansion went into effect in most states, the total number of people enrolled in the program did still increase by a respectable 187,958 people month over month.

This has resulted in a net enrollment increase of over 13.5 million people since the ACA expansion program went into effect two years ago, and a grand total of 71.8 million enrolled in the program nationally.

  • Nearly 71.8 million individuals were enrolled in Medicaid and CHIP in October 2015. 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.
  • 187,958 additional people were enrolled in October 2015 as compared to September 2015 in the 50 states that reported comparable September and October 2015 data (Arkansas is not included in this count).
  • Looking at the additional enrollment since October 2013 when the initial Marketplace open enrollment period began, among the 48 states reporting both October 2015 enrollment data and data from July-September of 2013, over 13.5 million additional individuals are enrolled in Medicaid and CHIP as of October 2015, a 23.6 percent increase over the average monthly enrollment for July through September of 2013.9 (Arkansas, Connecticut and Maine are notincluded in this count. Arkansas was included in monthly reports prior to September 2015, so the cumulative change reported in this month’s report is not comparable to the corresponding statistics in those reports.)

Naturally, there's a huge gap between the states which have expanded the program and those which haven't done so (yet):

  •  Among states that had implemented the Medicaid expansion and were covering newly eligible adults in October 2015, Medicaid and CHIP enrollment rose by nearly 31 percent compared to the July-September 2013 baseline period, while states that have not, to date, expanded Medicaid reported an increase of over 10.2 percent over the same period.

Finally, as always, you really have to add on another 950K people who were shifted to Medicaid from existing state-run programs, etc, prior to January 2014:

  • 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.12 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.

I haven't really been updating the Medicaid Graph for a few months now, partly because the increases are far less dramatic now that many expansion states are fairly close to maxing out their enrollment, while the rate of new states implementing the expansion has slowed tremendously. However, this update gives me a nice baseline to start with for Year Three of the expansion provision. I figure the numbers will likely have inched up another 500,000 between October and the end of January: