CMS releases Dec. 2022 enrollment data: Medicaid/CHIP enrollment reaches 92.3M (likely ~95M as of March w/U.S. territories)

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

In December 2022, 92,340,585 individuals were enrolled in Medicaid and CHIP.

  • 85,280,085 individuals were enrolled in Medicaid in December 2022, an increase of 425,110
  • 7,060,500 individuals were enrolled in CHIP in December 2022, an increase of 87,296 individuals from November 2022.
  • Since February 2020, enrollment in Medicaid and CHIP has increased by 21,690,345 individuals (30.7%).
    • Medicaid enrollment has increased by 21,474,995 individuals (33.7%).
    • CHIP enrollment has increased by 215,350 individuals (3.1%).

The Medicaid enrollment increases are likely driven by COVID-19 and the continuous enrollment condition in the Families First Coronavirus Response Act (FFCRA).

In December 2022, 2,360,820 applications for Medicaid and CHIP were submitted directly to states.

  • The number of applications submitted directly to states was 3 percent higher in December 2022 compared to November 2022.

In December 2022, 579,566 applications were transferred from the Federally Facilitated Marketplace (FFM) to states.

  • The number of transferred applications was 13 percent lower in December 2022 compared to November 2022.

As an aside, a couple of months ago 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, and another 425,000 from November to December.

I'm fairly certain that Medicaid/CHIP enrollment increased another ~400K or so in both January and February, which would put it at roughly 93.1 million. In March I'd imagine it leveled off (or only increased by a smaller amount) as some states like Idaho have already started jumping the gun on "Medicaid Unwinding."

However, there's more:

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 December 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 December, the grand total of Medicaid/CHIP enrollment as of March was likely around 95 million nationally.

This was likely the high water mark for Medicaid enrollment historically, and will likely remain that way for quite some time unless there's another pandemic which causes "continuous coverage" to be reinstated, the remaining ten non-expansion states all go ahead and expand the program or some other major policy shift occurs.