CHIP

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.

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

Thanks to the Biden-Harris Administration’s efforts to strengthen maternal health, an estimated 641,000 Americans annually are now eligible for essential care for a full year after pregnancy.

Originally posted 10/31/23; updated 11/08/23

Back in September, Amy Lotven of Inside Health Policy found an excellent scoop from a new CMS report hiding in plain sight:

New CMS data, quietly released in late August, show about 178,000 consumers chose a qualified health plan (QHP) through a state or federal exchanges after losing Medicaid and CHIP coverage in the first two months of the Medicaid unwinding. Those sign-ups through the end of May are more than three times the 54,000 enrollments that CMS reported in July, which reflected only the April numbers.

Last week I reported that at least 593,000 of the "Medicaid Unwinding" population (Americans who had their Medicaid or CHIP coverage terminated since the end of the COVID public health emergency's "Continuous Coverage" provision ended at the end of March) had shifted over to an ACA exchange plan as of the end of July (plus another 88K who enrolled in BHP plans).

As I noted at the time, perhaps 11% or so of the Unwinding population might move to ACA exchange policies instead when the dust settles on the ongoing unwinding process (12% or so if you include BHP enrollees).

Today, Amy Lotven of Inside Health Policy reports some additional data which indirectly supports this:

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

In July 2023, 91,521,722 individuals were enrolled in Medicaid and CHIP.

• In July 2023, 91,521,722 individuals were enrolled in Medicaid and CHIP.
  • 84,504,888 individuals were enrolled in Medicaid in July 2023, a decrease of 1,106,693 individuals (1.3%) from June 2023.
  • 7,016,834 individuals were enrolled in CHIP in July 2023, an increase of 17,565 individuals (0.3%) from June 2023.
• As of July 2023, enrollment in Medicaid and CHIP has decreased by 2,396,487 individuals 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 2,284,727 individuals (2.6%).
  • CHIP enrollment has decreased by 111,760 individuals (1.6%).
• Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,043,140 individuals (32.5%) to 93,918,209.
  • Medicaid enrollment increased by 22,709,822 individuals (35.4%).
  • CHIP enrollment increased by 333,318 individuals (4.9%).

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

October 16th: CMS approved a state plan amendment for Montana to extend postpartum coverage for a full year for individuals enrolled in Medicaid. The opportunity to extend postpartum coverage was made possible under the American Rescue Plan and made permanent in the Consolidated Appropriations Act, 2023. Montana’s approval marks 38 states, D.C., and the U.S. Virgin Islands that have extended postpartum Medicaid coverage for an entire year. This approval supports the CMS Maternity Care Action Plan and Biden-Harris Maternal Health Blueprint.

via KFF, the 12 states which haven't expanded postpartum Medicaid coverage to a full year include:

SEE IMPORTANT UPDATES AT BOTTOM.

Yesterday I crunched the numbers for two different reports from the Centers for Medicare & Medicaid services.

The first was the standard monthly Medicaid/CHIP enrollment report for June 2023:

In June 2023, 92,614,205 individuals were enrolled in Medicaid and CHIP.

• 85,614,581 individuals were enrolled in Medicaid in June 2023, a decrease of 1,169,095 individuals (1.3%) from May 2023.
• 6,999,624 individuals were enrolled in CHIP in June 2023, a decrease of 32,449 individuals (0.5%) from May 2023.

As of June 2023, enrollment in Medicaid and CHIP has decreased by 1,304,004 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.

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

In June 2023, 92,614,205 individuals were enrolled in Medicaid and CHIP.

• 85,614,581 individuals were enrolled in Medicaid in June 2023, a decrease of 1,169,095 individuals (1.3%) from May 2023.

• 6,999,624 individuals were enrolled in CHIP in June 2023, a decrease of 32,449 individuals (0.5%) from May 2023.

• As of June 2023, enrollment in Medicaid and CHIP has decreased by 1,304,004 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 1,175,034 individuals (1.4%).
  • CHIP enrollment has decreased by 128,970 individuals (1.8%).

• Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,043,140 individuals (32.5%) to 93,918,209
  • Medicaid enrollment increased by 22,709,822 individuals (35.4%).
  • CHIP enrollment increased by 333,318 individuals (4.9%).

Last month, Amy Lotven of Inside Health Policy found an excellent scoop from a new CMS report hiding in plain sight:

New CMS data, quietly released in late August, show about 178,000 consumers chose a qualified health plan (QHP) through a state or federal exchanges after losing Medicaid and CHIP coverage in the first two months of the Medicaid unwinding. Those sign-ups through the end of May are more than three times the 54,000 enrollments that CMS reported in July, which reflected only the April numbers.

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

HHS Takes Action to Provide 12 Months of Mandatory Continuous Coverage for Children in Medicaid and CHIP