CMS releases Oct. 2022 enrollment report: Medicaid/CHIP enrollment breaks 91.3M (likely ~93M w/U.S. territories)

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 October 2022, 65,236,564 people are enrolled in Medicare. This is an increase of 132,757 since the last report.

• 35,022,974 are enrolled in Original Medicare.

• 30,213,590 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

• 50,666,744 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.

Beginning this month, CMS’ Medicare enrollment data will include low-income subsidy enrollment, including counts of Part D enrollees receiving the full or partial low-income subsidy. Many stakeholders have requested this data and we are pleased to make it available. Detailed enrollment data can be viewed here.

 

That's right: 46.3% 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 October, 2022, 91,342,256 people are enrolled in Medicaid and CHIP. This is an increase of 462,322 since the last report.

• 84,374,871 are enrolled in Medicaid

• 6,967,385 are enrolled in CHIP

 

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

As I noted yesterday, CMS actually has two different reports on Medicaid enrollment: The monthly Medicaid & CHIP Enrollment Trend Snapshot (referenced above) and the Medicaid Budget & Expenditure System (MBES).

Each type of report includes some data that the other doesn't, but each also measures Medicaid enrollment a bit differently:

• Trend Snapshots are more up to date (through October 2022 instead of March 2022)

• 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.

• The other major difference: The MBES reports include Medicaid enrollees in the U.S. territories: American Samoa, Guam, N. Mariana Islands, Puerto Rico and the U.S. Virgin Islands.

Some of these actually cancel each other out: Some are higher in the Trend Snapshot reports while others are higher in the MBES counts. The only one which clearly stands out is the U.S. territory count in the MBES report, which stood at 1.57 million Medicaid enrollees as of March 2022. Assuming similar trends to the U.S. states, I presume it's slightly higher as of today, probably around 1.6 million, give or take.

When you add that 1.57M to the mix, along with the likely increases in the U.S. states & DC since October, the grand total of Medicaid/CHIP enrollment as of today is likely over 93 million nationally.