Ensuring Medicaid Eligibility Integrity by Addressing Concurrent Medicaid and Children’s Health Insurance Program (CHIP) Enrollment Across States
In 2024, an average of 1.2 million Americans each month appeared to be enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) in more than one state.2 These concurrent Medicaid and CHIP enrollments represent millions in excess state and federal dollars spent annually on managed care capitation rates and other costs for individuals who may no longer be eligible in one or more of the states in which they are enrolled. The Centers for Medicare & Medicaid Services (CMS) aims to ensure, as expeditiously as possible and within the bounds of the law, that individuals who are otherwise Medicaid- or CHIP-eligible are enrolled only in the Medicaid program or CHIP of their state of residence, not in multiple states’ programs. CMS is also committed to ensuring that Medicaid- and CHIP-eligible individuals are not improperly enrolled concurrently in Medicaid or CHIP and in subsidized Health Insurance Exchange coverage with advance payments of the premium tax credits (APTC) or cost-sharing reductions (CSR). CMS is committed to working with states to eliminate Medicaid and CHIP fraud, waste, and abuse, and ensuring that federal dollars are expended to provide only eligible individuals with health coverage.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 06, 2025
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