CMS releases Nov. 2022 enrollment report: Medicaid/CHIP enrollment reaches 91.8M (likely ~94M 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 November 2022, 65,372,781 people are enrolled in Medicare. This is an increase of 136,217 since the last report.

• 35,114,923 are enrolled in Original Medicare.

• 30,257,858 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

• 50,732,693 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. The data now include counts of Part D enrollees receiving the low income subsidy.

 

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 November 2022, 91,786,257 people are enrolled in Medicaid and CHIP. This is an increase of 444,058 since the last report.

• 84,815,742 are enrolled in Medicaid

• 6,970,515 are enrolled in CHIP

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

As an aside, a few weeks back when I posted my "Psychedelic Donut" breakout of healthcare coverage of the entire U.S. population as of January 2023, I noted:

While the pending end of the COVID pandemic Continuous Coverage requirement is about to lead to a massive Medicaid "Unwinding" starting in April, as of this moment I'm assuming that total Medicaid/CHIP enrollment has gone up by at least another million since October.

Well, sure enough, it went up 444,000 from October to November alone.

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 1.6M 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 around 94 million nationally.