CMS: Medicaid, CHIP Enrollment Rise by 3M Under ACA
Since last October, more than three million U.S. residents have enrolled in Medicaid or the Children's Health Insurance Program through the Affordable Care Act, according to preliminary data released Friday by the Obama administration, the New York Times reports.
For the report, the administration compared Medicaid and CHIP enrollment figures for February 2014 against the average monthly enrollment data from July through September 2013, just before the ACA's insurance exchanges launched (Pear, New York Times, 4/4).
According to the Washington Post, the administration previously only reported data on how many people it deemed eligible for the programs, instead of the number of people who actually were enrolled (Sun/Millman, Washington Post, 4/4).
In January, the administration said that more than 6.3 million people were determined to be eligible for Medicaid or CHIP through state-run agencies and exchanges from Oct. 1 until the end of December 2013 (California Healthline, 1/23).
More Details From Latest Data
According to CMS, 11.7 million people were determined to be eligible for Medicaid and CHIP from Oct. 1, 2013, through the end of February (O'Donnell, USA Today, 4/4). As of Feb. 28, total Medicaid and CHIP enrollment stood at 61 million across the 46 states that reported such data (Washington Post, 4/4).
So far, about half all of states and the District of Columbia have expanded, or are in the process of expanding, Medicaid under the ACA (New York Times, 4/4).
In an HHS blog post published Friday, HHS Secretary Kathleen Sebelius noted that states that have expanded Medicaid have seen a "much more dramatic increase" in enrollment compared with states that have not (Washington Post, 4/4).
Among states that had expanded their programs by February, CMS reported that Medicaid enrollment increased by an average of 8.3% to a total of 35 million beneficiaries. Meanwhile, Medicaid enrollment had increased by an average of 1.6% among states that did not expand Medicaid.
The Congressional Budget Office has projected that at least eight million people likely will obtain Medicaid or CHIP coverage under the ACA this year, which will raise federal spending by $19 billion, the Times reports.
Underreported Data
According to the Times, CMS noted the Medicaid and CHIP enrollment data are underestimates because several states did not report such data for February. In addition, the figures were characterized as preliminary because the federal government could determine some people eligible for Medicaid and grant them coverage retroactive to February (New York Times, 4/4).
The new data also do not reflect enrollment figures for March, when the administration launched a nationwide campaign to get millions more residents to sign up for coverage through the exchanges. In addition, the data do not take into account enrollees who signed up for Medicaid through HealthCare.gov, which faced technological problems that prevented the transfer of enrollment information to state Medicaid agencies.
CMS noted that:
- The enrollment data cover only people who qualified for full coverage, while the eligibility data cover people who were deemed eligible for partial or limited benefits;
- Some of the eligibility figures could include duplicates, but the enrollment figures do not; and
- Some of the individuals deemed eligible for Medicaid might have found alternative health coverage elsewhere.
Comments
Elizabeth Carpenter, a policy analyst with Avalere Health, cautioned against linking the Medicaid enrollment data directly to the ACA. She said, "In the expansion states, what we don't know, of these 3 million, how many are directly attributable to the expansion versus people who were eligible previously and have now enrolled because of increased awareness associated with the Affordable Care Act?" (Washington Post, 4/4).
According to the Times, some Republicans expressed concern that enrollment rates in private coverage in some states were lower than those for Medicaid. Sen. John Cornyn (R-Texas) said, "The administration seems particularly proud of the fact that [the ACA] has added hundreds of thousands of Americans to Medicaid." He added, "The problem is that Medicaid is a fundamentally broken program that is failing our neediest citizens" (New York Times, 4/4).
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