January 24, 2014 — More than 6.3 million U.S. residents were determined eligible for Medicaid or the Children's Health Insurance Program through state-run agencies and health insurance marketplaces as of the end of December, according to a report released Wednesday by CMS, CNBC reports (Mangan, CNBC, 1/22).
For the report, CMS officials used partial data from state agencies to calculate the number of eligibility determinations, starting in October (Adams, CQ HealthBeat, 1/22). According to CNBC, the figure does not include the estimated 750,000 eligibility determinations made through the federal health insurance exchange website (CNBC, 1/22).
The report does not provide a breakdown of individuals who were newly eligible for the programs under the Affordable Care Act's (PL 111-148) Medicaid expansion, those who renewed coverage or those who previously were eligible but had not enrolled (CQ HealthBeat, 1/22). Specifically, the report showed enrollments in Medicaid and CHIP increased by 20% in December compared with November. About 2.3 million U.S. residents were deemed eligible for Medicaid or CHIP in December (Viebeck, "Healthwatch," The Hill, 1/22). Further, eligibility determinations were 73% higher than the July 2013 through September 2013 average in states that have chosen to expand their Medicaid programs under the ACA, compared with a 3% increase in the 25 states that have not expanded their programs (Millman, Politico, 1/22).
HHS: Data Prove More States Should Participate in Expansion
In a blog post, HHS officials touted the data as proof that more states should expand Medicaid under the ACA. They wrote, "The increase in the number of Medicaid determinations across the country is encouraging, but more work is left to do to ensure that the millions of uninsured Americans eligible for these program gain coverage." They added, "Not only is expanding Medicaid coverage helping many people gain health coverage, it's a good deal for states: coverage for newly eligible adult beneficiaries is fully federally paid for under the [ACA] for the first three years, and never less than 90% for the years following" ("Healthwatch," The Hill, 1/22).
However, Matt Salo, executive director of the National Association of Medicaid Directors, took a more restrained view of the data, saying, "What many people don't read far enough to learn is that this number also can include people in some states who are eligible under pre-expansion -- the woodwork effect -- and whose Medicaid enrollment was simply renewed" (Begley/Morgan, Reuters, 1/22).