As I (and others) have written many times, closing the so-called "Medicaid Gap" is one of the trickiest challenges President Biden and Congressional Democrats face when it comes to strengthening and improving the Affordable Care Act.
Once again: Under the ACA, all Americans earning up to 138% of the Federal Poverty Level (FPL)... roughly $17,700/year for a single adult or around $36,500 for a family of four...were supposed to be eligible to join Medicaid regardless of their health status, whether they had kids and so forth.
This was supposed to be the case in all 50 states and the District of Columbia (I'm not sure about Puerto Rico or the other U.S. territories...many ACA provisions never applied to them in the first place).
A few weeks ago, after the Centers for Medicare & Medicaid (CMS) confirmed over 80 million Americans were enrolled in Medicaid or the CHIP program as of January 2021, I posted an analysis which looked at state Medicaid enrollment data beyond January.
While the "thru dates" vary from as early as February to as recent as June, my overall conclusion was that actual total Medicaid/CHIP enrollment as of last month has continued to grow, and now likely stands at more like 88 million. It's even conceivable that it's broken the 90 million threshold as of July.
As I noted:
Since then, the combination of sudden, massive unemployment combined with the Families First & CARES COVID Relief acts (which boost federal funding of Medicaid programs while also prohibiting states from disenrolling current Medicaid enrollees during the public health crisis) have resulted in overall Medicaid enrollment rising dramatically over the past year and a half.
Oklahoma's Medicaid Expansion will Provide Access to Coverage for 190,000 Oklahomans
Nearly 120,000 People Will Begin Receiving Full Medicaid Benefits on July 1
The Centers for Medicare & Medicaid Services (CMS) announced today that approximately 190,000 individuals between the ages of 19-64 in Oklahoma are now eligible for health coverage, thanks to Medicaid expansion made possible by the Affordable Care Act (ACA). On June 1, 2021, the state began accepting applications, and to date, over 120,000 people have applied for and were determined eligible to receive coverage. On July 1, these individuals will receive full Medicaid benefits, including access to primary and preventive care, emergency, substance abuse, and prescription drug benefits. Thanks to the American Rescue Plan (ARP), Oklahoma is eligible to receive additional federal funding for their Medicaid program, estimated to be nearly $500 million over two years. It is estimated that an additional 70,000 people in Oklahoma who have not yet applied are now eligible for coverage under Medicaid.
Our son's GF moved here (Seattle) last summer from Florida. She was a few months after returning from a teaching gig in Korea (where they met), and unemployed. In FL she wasn't eligible for Medicaid, but a couple weeks after she got here I realized she would in WA.
So she signed up and it's been great, b/c in fact she did need quite a bit of overdue health services.
Now they are moving to Oregon next month and I told her, "so you're going to sign up there, right?". She tells me, "I'm not eligible there".
She shows me the Federal Benefits.gov site, and it lists for Oregon the Florida-like limitations: you have to be a parent or pregnant or disabled, etc.
I go, "that's strange..." and look up the California eligibility. Same story.
I look up WA's own eligibility according to benefits.gov - same story!!! Supposedly she's not eligible for the very same coverage she's actually enjoying right now with full approval.
For the past couple of weeks, I've been on a marathon session of analyzing and graphing out total enrollment in Medicaid in every state for each month from 2014 until now (using estimates based on the best available data for the first part of 2021).
Now that I've completed this for all 50 states +DC, I'm bringing it all together into a single national graph showing how enrollment has changed over time.
Aside from the initial ramping up of enrollment after ACA Medicaid expansion went into effect in most states starting in early 2014 (and an odd drop-off/jump in California in the third quarter of 2017), enrollment was pretty steady at the national level...until COVID struck in early 2020.
I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.
For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources. Unfortunately, Wyoming isn't among them, though I've estimated January enrollment based on CMS's just-released Monthly Medicaid & Chip report (which use a slightly different methodology than the MBES reports).
Texas is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund)...and by far the largest.
Tennessee is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund).
South Dakota is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund).