8.9 Million Determinations for Medicaid and CHIP Eligibility between October and January

February 28, 2014

According to a new CMS report released today, between October and January, more than 8.9 million individuals were determined eligible for Medicaid or CHIP through state agencies and through state-based Marketplaces. More than 2 million people were informed in January that they are eligible for Medicaid and the Children’s Health Insurance Program (CHIP); more of those individuals are in states that have chosen to expand Medicaid coverage to more of their residents.

These numbers include both Medicaid and CHIP new eligibility determinations in states that expanded coverage; determinations made based on laws that predate the Affordable Care Act and for groups not affected by the health care law; and in some states, Medicaid renewals. These numbers do not include Medicaid eligibility determinations made through the Federally-Facilitated Marketplaces (HealthCare.gov).  Today’s report is the fourth in a series of monthly reports on state Medicaid and CHIP data. We anticipate reporting on Medicaid and CHIP enrollment in future months.

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 programs.  These gains are made possible by collaboration between CMS and the states that operate these programs on the ground.

The Affordable Care Act provides states with new opportunities to expand their Medicaid programs to meet the needs of more uninsured residents. In states that expand coverage, most individuals with incomes up to 133 percent of the Federal Poverty Level, or $15,521 for an individual and $31,721 for a family of four, will be eligible for Medicaid coverage that began 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.  Expanding coverage reduces hospitals’ uncompensated care, lowers “cost shifting” to businesses that see higher health insurance premiums as some of the costs of caring for the uninsured are passed on to them, and strengthens local economies.

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.

Read today's report.