Musk/Trump Regime posts claimed Dec. 2024 Medicaid/CHIP enrollment report: 78.8M, down 0.2% from Nov.

The Musk/Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

November 2024 Key Findings

Medicaid and CHIP Enrollment

• In December 2024, 78.8 million individuals were enrolled in Medicaid and CHIP.
  • 71.5 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
  • 41.4 million adults were enrolled in Medicaid, and there were 37.4 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

• In December 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 3.0 million applications, or 11 percent more applications, as compared to November 2024.
• The number of applications received has increased by 30 percent since December 2023 and increased by 84 percent since December 2022.

Total Medicaid/CHIP enrollment in December 2024 dropped slightly from November, by 171,000 people or 0.2%.

The all-time high enrollment watermark for Medicaid/CHIP was in April 2023, when it officially hit 94.1 million Americans (95.7 million when you include the U.S. territories).

It's important to note that 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 measures Medicaid enrollment a bit differently:

• The MBES report is 11 months out of date (through June 2024) while the Trend Snapshot is only 5 months outdated (through December 2024).

• 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.

The MBES numbers for U.S. territories stood at 1.54 million Medicaid enrollees as of June 2024. If you add those to the Trend Snapshot total for the 50 states +DC, it comes in at 80.4 million as of December 2024.

It's also worth noting that ACA Medicaid Expansion enrollment specifically  was 20.9 million as of June 2024 according to the MBES report, down around 3 million from the all-time high it reached in May 2023.

Finally, the summary report mentions in passing that ACA exchange enrollment in Qualified Health Plans (QHPs) was ~21.6 million in December, while Basic Health Plan (BHP) enrollment was 1.8 million.

Neither of these is surprising or unexpected, but it's noteworthy that these numbers are being officially recognized by the Musk/Trump admin under the circumstances. It's also worth noting that 21.6 million being enrolled in effectuated exchange coverage in December is higher than the 21.4 million who had selected ACA exchange plans during the 2024 Open Enrollment Period.

As for my concerns about potential manipulation of data by the Musk/Trump Admin, once again I'm still not seeing any obvious red flags in this month's report.

Total Medicaid/CHIP enrollment is reported as being down, but not by a crazy amount (around 0.2% nationally from Nov - Dec). At the state level, seven states saw a drop of more than 1% (Maryland had the highest drop at -2.4%)...while one state (Louisiana) had an increase of over 1%.

Note that Rhode Island's December data is unavailable due to a massive data security breach they were dealing with at the time.

Again, I'll continue to keep a close eye on this, but it doesn't look like Musk/Trump's CMS are messing with this data as of yet.