Charles Gaba's blog

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of June 2024:

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

  • In July 2024, 79,560,396 individuals were enrolled in Medicaid and CHIP, a decrease of 403,074 individuals (0.5%) from June 2024.
    • 72,429,055 individuals were enrolled in Medicaid in July 2024, a decrease of 441,475 individuals (0.6%) from June 2024.
    • 7,131,341 individuals were enrolled in CHIP in July 2024, an increase of 38,401 individuals (0.5%) from June 2024.
  • As of July 2024, enrollment in Medicaid and CHIP has decreased by 14,455,287 individuals (15.4%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 14,440,102 individuals (16.6%).
    • CHIP enrollment has decreased by 15,185 individuals (0.2%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,109,188 individuals (32.6%) to 94,015,683.
    • Medicaid enrollment increased by 22,819,861 individuals (35.6%).
    • CHIP enrollment increased by 289,327 individuals (4.2%).

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

  • In June 2024, 79,963,470 individuals were enrolled in Medicaid and CHIP, a decrease of 851,310 individuals (1.1%) from May 2024.
    • 72,870,530 individuals were enrolled in Medicaid in June 2024, a decrease of 838,377 individuals (1.1%) from May 2024.
    • 7,092,940 individuals were enrolled in CHIP in June 2024, a decrease of 12,933 individuals (0.2%) from May 2024.
  • As of June 2024, enrollment in Medicaid and CHIP has decreased by 13,943,010 individuals (14.8%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 13,860,029 individuals (16.0%).
    • CHIP enrollment has decreased by 82,981 individuals (1.2%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,999,985 individuals (32.4%) to 93,906,480.
    • Medicaid enrollment increased by 22,681,263 individuals (35.4%).
    • CHIP enrollment increased by 318,722 individuals (4.6%).

Originally posted 9/09/24

Ah, at last, another state which includes both the average requested rate changes for 2024 as well as the number of enrollees each carrier has for both the individual and small group markets in clear, transparent language!

Generally, according to NC Insurance laws, health insurance rates must not be excessive, inadequate, or unfairly discriminatory, and must exhibit a reasonable relationship to the benefits provided in the policy.

Overall, individual market carriers in North Carolina are requesting 7% rate increases in 2025 for unsubsidized policies, while small group market carriers are asking for a 6.5% bump. It's worth noting that one of the three (!) UnitedHealthcare divisions is pulling out of the NC small group market next year for whatever reason.

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

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved section 1115 demonstration amendments that allow, for the first time ever, Medicaid and Children’s Health Insurance Program (CHIP) coverage of traditional health care practices provided by Indian Health Service (IHS) facilities, Tribal facilities, and urban Indian organizations (UIO). Today’s action is expected to improve access to culturally appropriate health care and improve the quality of care and health outcomes for tribal communities in Arizona, California, New Mexico, and Oregon, and will support IHS, Tribal, and UIO facilities in serving their patients. 

Currently, the Affordable Care Act's preventative services mandate requires most employer-provided & individual market healthcare policies to provide coverage for the following types of birth control products & services:

Plans in the Health Insurance Marketplace® must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.

Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider — even if you haven’t met your  deductible

Covered contraceptive methods

FDA-approved contraceptive methods prescribed by a woman’s doctor are covered, including:

Originally posted 9/12/24

Unfortunately, South Carolina is another state where they don't make unredacted rate filings available, either on the state insurance dept website, the federal Rate Review website or the SERFF database.

As a result, I'm limited to unweighted averages for both the individual and small group markets:

  • Individual Market: FLAT
  • Small Group Market: +6.7%

I'm estimating the total individual market at perhaps 700,000 people, based on an assumption that 80% are enrolled in on-exchange plans.

It's worth noting that Cigna Healthcare is dropping out of the South Carolina individual market next year, while Aetna is pulling out of the small group market (see below).

Back in June, I ran a state-by-state analysis which provided estimates of just how much various households would see their net individual market premiums jump starting in 2026 if the upgraded financial subsidies originally included in the American Rescue Plan Act (and later extended by the Inflation Reduction Act) are allowed to expire at the end of 2025, as is currently scheduled to happen without legislative action.

This week, the Robert Wood Johnson Foundation (RWJF)* has published their own take on the financial impact on enrollees if the IRA subsidies are allowed to expire. In this case, however, they're approaching it from a slightly different angle: They're focusing specifically on the approximately 1.7 million ACA exchange enrollees who earn more than 400% of the Federal Poverty Level (FPL).

*Disclosure: RWJF is a sponsor of this website.

Washington HealthPlan Finder

via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange (Exchange) and Health Care Authority (HCA) are pleased to announce Cascade Select will be available in all 39 Washington counties in 2025, with the addition of the two final counties: Lincoln and Grays Harbor.

“Cascade Select has grown significantly since it launched in 2021, with more than 75,000 Washington Healthplanfinder™ customers enrolled today,” reported Ingrid Ulrey, Chief Executive Officer for the Exchange. “In 2025, Cascade Select will be the lowest premium in 26 counties for silver health plans. Cascade Select has lower premiums compared to other health plans on the market because of the unique health care cost controls that save more money on premiums for consumers.”

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