CMS releases April 2022 enrollment report: Medicaid/CHIP now covers ~88.3 million Americans (could actually be 90M+)

via the Centers for Medicare & Medicaid Services (CMS), by email:

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

As of April 2022, 64,449,451 people are enrolled in Medicare. This is an increase of 88,177 since the last report.

• 34,879,219 are enrolled in Original Medicare.

• 29,570,232 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

• 50,011,957 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.

Over 12 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs.

Detailed enrollment data can be viewed here.

That's right: Over 45% of all Medicare enrollees are now enrolled in Medicare Advantage, the privately-administered version of the program. This trend has been growing every year for the past couple decades, for good or for bad.

Medicaid and Children’s Health Insurance Program (CHIP)

As of April 2022, 88,274,847 people are enrolled in Medicaid and CHIP. This is an increase of 375,152 since the last report.

• 81,195,571 are enrolled in Medicaid

• 7,079,276 are enrolled in CHIP

For more information on Medicaid/CHIP enrollment, including enrollment trends, visit here.

Last June, CMS confirmed that total Medicaid/CHIP enrollment had officially broken 80 million Americans...as of January 2021. However, this was six months out of date and, just as significantly, utilized the Medicaid/CHIP Enrollment Trends Snapshot report. The problem with this is that the Trends Snapshot reports leave out some Medicaid enrollees whcih are included in a different CMS report, the Medicaid Budget & Expenditure System (MBES):

• The MBES count includes individuals enrolled in limited benefit plans and the Performance Indicator count does not include such individuals.

• The MBES data represents the count of unduplicated individuals enrolled in the state’s Medicaid program at any time during each month in the quarterly reporting period, while the Performance Indicator data captures the count of individuals enrolled on the last day of the month.

• The MBES count only includes individuals whose coverage is funded through Medicaid (title XIX of the Social Security Act), while the published Performance Indicator also includes individuals funded through CHIP (title XXI of the SSA).

• MBES and Performance Indicator data may be derived from different state systems.

• Retroactive state adjustments to MBES or Performance Indicator data may be in progress.

• States have likely generated MBES data and Performance Indicator data from state systems on different dates.

Some of these actually cancel each other out; the first two favor the MBES counts while the third makes the Performance Indicator total higher. The last three bullets don't really lean one way or another.

However, there's another important difference: The MBES reports include Medicaid enrollees in the U.S. territories (Puerto Rico, Guam, etc.) which aren't included in the Performance Indicator reports for some reason.

As a result of the above, along with piecing together some updated data from individual states, I estimated that actual Medicaid/CHIP enrollment was more like 88 million people as of June 2021.

With this latest report from April 2022, the Performance Indicator total is now nearly 88.3 million...which means that the MBES report has almost certainly broken 90 million or higher by now.