Medicaid, CHIP enrollment grew by 4 million during COVID-19

More than 4 million additional people enrolled in Medicaid and the Children’s Health Insurance Program between February and June, according to a report from CMS on Wednesday.

Medicaid and CHIP enrollment grew from almost 71 million people in February to nearly 75 million in June, representing a 5.7% increase since the public health emergency began in March. Medicaid enrollment grew 6.2% during that period, with nearly 4 million more people enrolled in the program. CHIP grew about 0.5%, with enrollment increasing by more than 23,000 beneficiaries.

CMS said enrollment spiked again with the Families First Coronavirus Response Act’s continuity of coverage requirement.

According to the agency, Medicaid and CHIP enrollment increased in all states except Montana, which reported an enrollment decrease.

“As of August 31, 2020, Montana had not yet provided an explanation for its Medicaid and CHIP enrollment declines in the first half of 2020,” the report said.

Health Management Associates predicted in April that Medicaid enrollment could increase 25%, from 71 million people in December 2019 to 89 million people, by the end of 2020, depending on how the economy performed.

The economic recession caused by the COVID-19 pandemic led many people to lose their jobs and employer-sponsored health coverage. But Medicaid enrollment growth has been driven by states pausing eligibility redetermination processes during the public health crisis. Health insurers and state health departments say they have not seen significant enrollment growth among people who have lost job-based health coverage.

States could increasingly turn to provider rate cuts to help address budget shortfalls and growing Medicaid enrollment. According to the progressive Center on Budget and Policy Priorities, states face average budget shortfalls of 10% in 2020 and 20% in 2021. On average, states spend more than 20% of their own money on Medicaid, a National Association of State Budget Officers analysis found. The NASBO estimates federal and state Medicaid spending accounted for almost 30% of total state spending in 2018.


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