The Centers for Medicare & Medicaid Services (CMS) released its monthly Medicaid and Children’s Health Insurance Program (CHIP) Enrollment Trends Snapshot today, showing a continued increase in enrollment for these programs. This latest summary report captures impacts of the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE) by tracking total Medicaid and CHIP program enrollment trends for adults and children over a 12-month period. CMS initially reported the impact of COVID-19 on increasing Medicaid and CHIP enrollment in the Enrollment Trends Snapshot released in September 2020. For the first time, the Snapshot now also includes a summary of the total number of applications submitted for these programs. Following months of decline in applications early in the PHE, today’s data show an increase in applications beginning in June, with a significant uptick in applications between July and August 2020.
From February 2020, the month before President Trump declared a national emergency under the Stafford Act, to August 2020, national Medicaid and CHIP enrollment increased by nearly 5.9 million individuals, or almost 8.3%. During this time period, Medicaid enrollment increased by over 5.8 million individuals, or 9.1%, whereas CHIP enrollment increased by 33,000 individuals, or 0.5%.
The increase in enrollment is largely driven by the COVID-19 public health emergency and enactment of the Families First Coronavirus Response Act (FFCRA) continuous enrollment (maintenance of effort) requirement. This requirement makes a temporary 6.2% increase in matching funds through Federal Medical Assistance Percentages (FMAP) for certain expenditures available to states and also includes a requirement to maintain Medicaid enrollment for beneficiaries except in a few circumstances. New data on the trend in applications further suggests that while new enrollment has had some impact on the overall increase in Medicaid and CHIP enrollment during the PHE, it has not been the key driver, as evidenced by enrollment growing at a far greater rate than applications. This trend suggests that enrollment increases are likely attributed to existing enrollees remaining eligible due to the maintenance of effort requirements; however, CMS will continue to monitor these trends.
“Over the last four years, the Trump Administration has shined a bright light on the Medicaid program because we know that transparency promotes accountability.” said CMS Administrator Seema Verma. “In the midst of a pandemic of generational scope and fury, it has never been more important to understand the underlying drivers of enrollment trends and the impact of new congressional requirements.”
Medicaid and CHIP play a vital role in helping states and territories respond to public health events, like COVID-19. To assist states and territories in their response to COVID-19, CMS developed numerous strategies to support Medicaid and CHIP operations and enrollees in times of crisis, including granting states more flexibility in their Medicaid and CHIP operations. Given the importance of Medicaid and CHIP coverage during a PHE, many of these flexibilities and policy options, such as presumptive eligibility and continuous eligibility, expedite enrollment and further retention in the programs. Through an Interim Final Rule with Comment, CMS also provided states with clearer guidance and flexibility to effectively manage their programs within the FFCRA Medicaid maintenance of effort enrollment requirement. Many of the flexibilities CMS developed to help states and territories in their response to COVID-19 are available here.
Today’s snapshot is a product of the Center for Medicaid and CHIP Services (CMCS) Medicaid and CHIP Coverage Learning Collaborative (MACLC), which monitors Medicaid and CHIP enrollment trends, primarily using the CMS Performance Indicator (PI) data reported to CMS by state Medicaid and CHIP agencies. PI data reflects key Medicaid and CHIP business processes – including applications, renewals, eligibility determinations, and enrollment.
The Enrollment Trends Snapshot, which is released monthly, is available here: https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot/index.html.
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