CMS

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

  • In March 2024, 82,751,338 individuals were enrolled in Medicaid and CHIP, a decrease of 636,453 individuals (0.8%) from February 2024.
    • 75,645,578 individuals were enrolled in Medicaid in March 2024, a decrease of 644,997 individuals (0.8%) from February 2024.
    • 7,105,760 individuals were enrolled in CHIP in March 2024, an increase of 8,544 individuals (0.1%) from February 2024.
  • As of March 2024, enrollment in Medicaid and CHIP has decreased by 11,116,668 individuals (11.8%) 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 11,084,981 individuals (12.8%).
    • CHIP enrollment has decreased by 31,687 individuals (0.4%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,023,434 individuals (32.5%) to 93,868,006.
    • Medicaid enrollment increased by 22,681,263 individuals (35.4%).
    • CHIP enrollment increased by 342,171 individuals (5.0%).

Along with posting detailed data on February effectuated enrollment by state since 2017 yesterday, the Centers for Medicare & Medicaid Services (CMS) also included a spreadsheet with monthly effectuated enrollment broken out by state for every year since 2016.

While it's unfortunate that neither 2014 nor 2015 were included, I have partial data for the first two years of the ACA exchanges from a similar post I put together back in 2019.

It's important to understand the difference between someone selecting a Qualified Health Plan (QHP) from one of the ACA exchanges during the Open Enrollment Period and someone actually being enrolled in an effectuated policy...that is, just because you sign your family up for a policy on HealthCare.Gov or a state-based exchange, you aren't considered effectuated until you actually pay your first monthly premium.

Earlier this afternoon, the Centers for Medicare & Medicaid Services (CMS, which should really be CMMS) released a whole bunch of much-awaited (by healthcare wonks) Effectuated Enrollment data for Affordable Care Act on-exchange enrollment.

While nearly 21.5 million Americans selected Qualified Health Plans (QHPs) via the federal and state ACA exchanges/marketplaces during the official 2024 Open Enrollment Period (along with an additional 1.3 million signing up for a Basic Health Plan (BHP) program in New York & Minnesota, which CMS continues to inexplicably treat as an afterthought in such reports), not all of them actually pay their first monthly premium (for January) for various reasons:

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.

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):

  • In February 2024, 83,387,167 individuals were enrolled in Medicaid and CHIP, a decrease of 654,280 individuals (0.8%) from January 2024.
    • 76,289,951 individuals were enrolled in Medicaid in February 2024, a decrease of 640,417 individuals (0.8%) from January 2024.
    • 7,097,216 individuals were enrolled in CHIP in February 2024, a decrease of 13,863 individuals (0.2%) from January 2024
  • As of February 2024, enrollment in Medicaid and CHIP has decreased by 10,480,839 individuals (11.2%) 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 10,440,608 individuals (12.0%).
    • CHIP enrollment has decreased by 40,231 individuals (0.6%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,992,937 individuals (32.4%) to 93,868,006.
    • Medicaid enrollment increased by 22,650,766 individuals (35.3%).
    • CHIP enrollment increased by 342,171 individuals (5.0%).

A month or so ago I noted that as ugly as the massive number of Americans who've had their Medicaid or CHIP coverage terminated is (nearly 22 million people as of last week, via KFF), there's some important mitigating factors to keep in mind (updated w/latest data):

Just over a year ago, the Associated Press reported that the Biden Administration planned on opening up eligibility for ACA exchange, Basic Health Program, Medicaid & CHIP coverage to hundreds of thousands of Americans who have Deferred Action of Childhood Arrivals status:

President Joe Biden is set to announce that his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants brought to the U.S. illegally as children, according to two U.S. officials briefed on the matter.

The action will allow participants in the Obama-era Deferred Action for Childhood Arrivals program, or DACA, to access government-funded health insurance programs. The officials spoke on the condition of anonymity to discuss the matter before the formal announcement on Thursday.

As I noted at the time:

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.

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