Medicaid and CHIP Eligibility Determinations Continue Positive Growth in November

Posted December 20, 2013

Medicaid and the Children’s Health Insurance Program (CHIP) eligibility determinations continue to grow in November, especially in states that have chosen to expand coverage to more of their residents, according to a new CMS report released today.

According to the report, more than 1.7 million people have been determined eligible to enroll in Medicaid or CHIP in the month of November through state Medicaid and CHIP agencies and through State-based Marketplaces. CMS also finalized October eligibility determinations resulting in a change from 1.4 million to 2.1 million, bringing the total eligibility determinations in October and November to 3.9 million. These numbers include both Medicaid and CHIP renewals and new eligibility determinations in November.

Because of the Affordable Care Act, many consumers can enroll in new affordable private health insurance options in the Health Insurance Marketplace, and many others are now eligible for their state’s Medicaid or CHIP programs.

These gains are made possible by collaboration between CMS and the states operating their programs on the ground. For example, states have been taking advantage of flexible, innovative ways to get people enrolled. Last spring, CMS released a set of options states could use to enroll Medicaid beneficiaries. One option is to reach out to people who qualify for the Supplemental Nutrition Assistance Program (SNAP), because they are also likely to be eligible for Medicaid.

The Affordable Care Act provides states with new opportunities to expand their Medicaid programs to meet the needs of more uninsured residents.  Iowa recently joined the growing number of states that have expanded Medicaid for their residents. In states that expand coverage, most individuals with incomes up to 133 percent of the Federal Poverty Level, or $15,282 for an individual and $31,322 for a family of four, will be eligible for Medicaid coverage that begins January 1, 2014.

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 Affordable Care Act for the first three years, and never less than 90 percent for the years following.

The increase in the number of applications submitted and in Medicaid determinations across the country is encouraging, and CMS looks forward to sharing additional information. Today’s report is the second in a series of monthly reports on state Medicaid and CHIP data. The data were reported to CMS from state Medicaid and CHIP agencies as part of the Medicaid and CHIP Performance Indicator process and supplements data on Marketplace activity released by HHS.