As long as no one is thrown off Medicaid, will enrollment keep growing by 1% per month?
I am beginning to wonder. I gather that no one has a precise idea what percentage of Medicaid enrollees are disenrolled every month by state income checks and eligibility redeterminations. The Families First Act paused those disenrollments for the duration of the national emergency -- as of now, through the end of March -- though a new interim final rule issued by Seema Verma's CMS appears to give states a green light to deem some past enrollments "invalid" and void them.
Of course, people continue to disenroll from Medicaid -- when they get a job with affordable insurance, or marry someone with insurance, or move, or age into Medicare (at which point the income thresholds for Medicaid drop in most states), or age out of CHIP, or die...etc. etc. It also seems clear that with 5 million more unemployed in November than in February, despite a snap-back from 14 million newly unemployed at the May peak, demand for Medicaid has grown.
At the same time, the Kaiser Family Foundation recently found that the ranks of those insured through employers have decreased only modestly (-1.5%) in the pandemic. Medicaid enrollment, meanwhile, has continued to grow by 1% per month or more in recent months -- at least by my compilation of state monthly enrollment reports, which shows somewhat more growth that CMS's time-lagged official monthly tally.* Certainly a significant portion, and possibly a very large portion of the enrollment growth is a result of the pause in disenrollments.
Below is an update to my 32-state tally through October. California has updated its numbers, with modest changes from February through September (the state considers tallies final after 12 months). I should arguably take Illinois out of the sample, as it's now lagging severely, but I don't think my estimates (in green) are likely to change all-state totals much.
Medicaid enrollment in 32 states, February-October 2020
Sources: State monthly Medicaid reports (see this post, at bottom).
Medicaid expansion states in blue; nonexpansion states in red; quasi-expansion in purple
The growth rates recorded here suggest that national Medicaid/CHIP enrollment has reached 79 million. When CMS tallies reach October, perhaps they'll show total enrollment at around 78 million.
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CMS Medicaid tallies differ somewhat from state reports in the programs they cover. The table in this post includes the percentage of CMS total reflected in each state-published total.