Montana: Medicaid expansion enrollment up 18% since COVID hit; total Medicaid up 14%


I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In some states I've been able to get more recent enrollment data from state websites and other sources.

Today I'm presenting Montana.

For enrollment data from January 2021 on, I'm relying on adjusted estimates based on raw data from the Montana Dept. of Public Health & Human Services.

ACA expansion in Montana didn't launch until 2016. It gradually ramped up over the next year or two and peaked at around 260,000 in 2018 before gradually dropping off to around 240,000 in early 2020...right before the COVID pandemic hit.

(I have no idea what caused that unusually sharp drop-off in early 2015.)

Since then, Medicaid enrollment has climbed back up again, with the non-ACA numbers increasing 11.8% and expansion going up by 18.3% for an overall increase of 14.2% over pre-COVID levels.

Maryland has 1,084,225 residents according to the 2020 U.S. Census. As of March 2021:

  • around 273,000 are enrolled in Medicaid overall, or around 25% of the population
  • around 168,000 are enrolled in non-ACA Medicaid
  • around 105,000 are enrolled in ACA Medicaid expansion.
  • Add in the ~38,000 subsidized ACA exchange enrollees and that's around 143,000 Montana residents who would lose healthcare coverage if the Supreme Court strikes down the Affordable Care Act, or 13.2% of the state population.