Medicaid & CHIP: February 2014 Monthly Applications, Eligibility Determinations, and Enrollment Report
Overview
Today CMCS is announcing that in February, an estimated 3 million additional individuals enrolled in Medicaid and CHIP. This announcement comes as part of the release of the fifth in a series of monthly reports on state Medicaid and Children’s Health Insurance Program (CHIP) data, and represents state Medicaid and CHIP agencies’ eligibility activity for February 2014, which coincided with the fifth month of the Health Insurance Marketplace Open Enrollment. This report includes state data and analysis on applications to Medicaid and CHIP agencies and the State-Based Marketplaces, as well as eligibility determinations made by these agencies. This month, for the first time, the report also includes state data on total enrollment in the Medicaid and CHIP programs.
Background on Data
In earlier reports, the Centers for Medicare and Medicaid Services (CMS) presented the number of people determined eligible for Medicaid and CHIP by their State Medicaid Agencies and through state-based Marketplaces each month, and also cumulatively since the beginning of open enrollment. In January, that cumulative number was 8.9 million people, and in February, that number rose to 11.7 million people determined eligible for Medicaid and CHIP. The February 2014 report also includes new data: 3 million additional individuals have enrolled in these programs. The new total enrollment data is a point in time count of all individuals enrolled in the Medicaid and CHIP program, and is unduplicated.
CMS arrived at the new total enrollment number by taking the difference between the total Medicaid and CHIP February enrollment numbers for those states that reported both February monthly data and data from the period prior to the start of Marketplace Open Enrollment. In those 46 states enrollment was 61,032,021 at the end of February, compared to 58,012,045 in the period prior to the start of Marketplace Open Enrollment.
It is important to note that the enrollment numbers reported today are underestimates of what the actual enrollment for February will ultimately be. There are several reasons for this:
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- Not all states are reporting.
- The data are preliminary, and do not include most individuals who will later be found eligible for Medicaid effective in February.
It’s also important to note that this data is not comparable to our count of individuals determined eligible in February or cumulatively over the open enrollment period. There are several key reasons why the new total enrollment numbers are different from eligibility determinations:
- The enrollment numbers only include individuals eligible for full benefits coverage while the determinations numbers include individuals receiving all types of coverage (for example, individuals only eligible for help paying their Medicare premiums).
- The enrollment number in this report represents unduplicated individuals enrolled in the programs. Determination numbers are not an unduplicated count and some states included renewals.
- Enrollment numbers—unlike the determination numbers—reflect coverage losses as well as coverage gains. Some individuals who were previously eligible for Medicaid are now eligible instead for Marketplace coverage or job-based coverage, for example.
Future Reporting
All 50 states and the District of Columbia are in the process of implementing the ACA simplifications to the Medicaid and CHIP application for enrollment. They are also carrying out ACA simplifications for eligibility determination processes, as well as making technology upgrades to transition to streamlined, data-driven eligibility determination systems. As states shift to these new eligibility and enrollment systems, we will continue to see improvements in reporting capacity.