CMS: 88K more "Unwinding" folks shifted to ACA exchange/BHP plans in May across 18 SBM states

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

With the end of this continuous coverage as of March 31st, 2023, healthcare advocates have been warning that millions of people would lose coverage, including many who are still actually eligible...and sure enough, as of August 1st, at least 24.8 million Medicaid enrollees have lost coverage so far, of whom a stunning 69% (17.1 million) were kicked off the program for purely procedural reasons--that is, failure to return a form or, in some cases, state administrations either mistakenly or deliberately sweeping entire families off the programs if a single member is no longer eligible.

The good news is that this doesn't mean that all 24.8 million of these folks are uninsured now.

Some of them have moved to employer coverage, Medicare or even rejoined Medicaid/CHIP after re-applying & being found to be eligible after all (in some cases they're no longer eligible via one criteria but are now eligible via a different one, like people in South Dakota and North Carolina which each expanded Medicaid mid-year).

Others are applying for and enrolling in ACA exchange coverage, often heavily subsidized.

The Centers for Medicare & Medicaid Services (CMS) have been tracking how many of the Unwinding population are applying for, qualifying for and actually enrolling in ACA exchange coverage, and is posting updated reports monthly.

As of April 2024, at least 5.1 million Americans who had seen their Medicaid/CHIP coverage terminated during the Unwinding process had replaced it with either ACA exchange coverage (usually heavily subsidized) or Basic Health Plan (BHP) policies in New York & Minnesota specifically.

Unfortunately, starting with the May 2024 report (released in August), CMS is phasing out tracking some of the data:

As of August 2024, CMS is no longer releasing the “HealthCare.gov” metrics. Historical data between July 2023-July 2024 will remain available. The “HealthCare.gov Transitions” metrics, which are the CAA, 2023 required metrics, will continue to be released.

What this boils down to is that some of the data I need to track the 32 states hosted on the federal exchange (HealthCare.Gov) is no longer easily available. Oddly, they're still releasing the same detailed data for the 19 state-based exchange (SBM) states (the overlap is due to Virginia transitioning from FFM to SBM status halfway through the Unwinding period).

What this means is that I'm unable to continue tracking this data nationally, although I can still do so for the 18 SBM states (again, I can't include Virginia since it shifted from one category to the other).

As of April, across the 33 FFM states, 5.2 million of those who lost Medicaid/CHIP covereage were determined to be eligible for ACA exchange plans (89% subsidized); of those, 3.88 million actually enrolled in an ACA policy. Another 630,000 were determined to still be eligible for Medicaid/CHIP after all.

For the 19 SBM states, as of April, 3.47 million had been determined eligible for ACA exchange plans (63% subsidized); of those, 767K actually enrolled in one. Another 472K were eligible for BHP coverage; 425K of those actually signed up.

This made for a total of 5.07 million "Unwinding" folks transitioning to exchange QHPs or BHPs thru April 2024.

For May, again, I only have the updated data available for the 19 SBM states...and it's actually only 18 due to Virginia's status change:

Overall, around 51,000 more members of the Unwinding population enrolled in exchange QHPs in May across these 18 SBM states, while another 36.8K enrolled in BHP plans in MN/NY. That makes for a net QHP/BHP enrollment increase of 7.5% from April to May.

I have no idea whether that's representative of the other states, but if so, it suggests that perhaps 5.45 million people had moved from Medicaid/CHIP to QHPs/BHPs as of May 2024...or around 382,000 more than in April.

I'll update/revise this post if I'm able to acquire the necessary May data for the FFM states after all.