Medicaid and Exchange Enrollment Update – December 2016/January 2017

This week, we reviewed updated reports issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “December 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on February 28, 2017. Additionally, we review 2017 Exchange enrollment data from the “Health Insurance Marketplaces 2017 Open Enrollment Period: Final State-Level Public Use File,” published by CMS on March 15, 2017. Combined, these reports present a picture of Medicaid and Exchange enrollment at the beginning of 2017, representing more than 74 million Medicaid and CHIP enrollees and more than 12 million Exchange enrollees.

Key Takeaways from Medicaid Enrollment Report

• Across all 50 states and DC, Medicaid and CHIP enrolled more than 74.1 million individuals as of December 2016.
• Medicaid and CHIP enrollment is up nearly 2.4 million members since December 2015, a 3.3 percent increase in enrollment.
• From December 2015 to December 2016, six states saw double-digit percentage growth in Medicaid and CHIP – Montana (33.6 percent); Alaska (32.0 percent); Louisiana (31.4 percent); Florida (21.3 percent); Arkansas (13.0 percent); and Maryland (11.1 percent).
• During 2016, six states (Alabama, District of Columbia, Illinois, Michigan, New Hampshire, and Utah) saw enrollment growth between 0 percent and 1 percent. Meanwhile, 12 states (Delaware, Georgia, Maine, Massachusetts, Minnesota, Mississippi, New York, North Dakota, Oregon, Vermont, Wisconsin, Wyoming) saw enrollment decline across Medicaid and CHIP.
• Medicaid and CHIP enrollment is up nearly 16.3 million (more than 28 percent) from the “Pre-Open Enrollment” period, defined as July 2013 through September 2013.
• The top five states in percentage growth of Medicaid and CHIP enrollment since the Pre-Open Enrollment period are Kentucky (102.8 percent), Nevada (87.5 percent), Colorado (75.5 percent), Arkansas (70.3 percent), and New Mexico (69.3 percent).
• The top five states in percentage growth of Medicaid and CHIP among states that did not expand Medicaid are Tennessee (31.1 percent), North Carolina (26.9 percent), Idaho (25.6 percent), Florida (17.4 percent), and Missouri (15.4 percent).
• The top five states in total enrollment growth of Medicaid and CHIP are California (4.15 million), New York (712,000), Washington (693,000), Florida (642,000), and Ohio (630,000).

Table 1 – Overall U.S. Medicaid/CHIP Enrollment Growth – Pre-Open Enrollment Monthly Average through December 2016

Key Takeaways from 2017 Exchange Enrollment Report

• Final Exchange enrollments for the 2017 plan year, published in March 2017, showed Qualified Health Plan (QHP) plan selections of more than 12.2 million across all 50 states and DC.
• 2017 QHP selections are down nearly 466,000 from 2016 QHP selections, a decline of 3.7 percent across all 50 states and DC.
• From 2016 to 2017, six states saw double-digit percentage growth in QHP selections. Three were State-Based Marketplace (SBM) states: Minnesota (31.7 percent); Massachusetts (24.7 percent); and Washington (12.4 percent). The other three were Federally Facilitated Marketplace (FFM) states: Hawai’i (30.0 percent); South Dakota (13.9 percent); and Utah (12.3 percent).
• A total of 15 states saw declines in QHP selections between 0 percent and negative 5 percent. Another nine states saw declines of negative 5 percent to negative 10 percent. A total of 11 states saw double-digit percentage declines in QHP selections from 2016 to 2017.
• Overall, the 12 states with SBMs saw growth of nearly 2 percent from 2016 to 2017, while all other Exchange/Marketplace administration models saw declines in enrollment.

Table 2 – Overall U.S. Exchange QHP Selection Growth – February 2016 through January 2017

The table on the following page (Table 3) provides state-level data on Medicaid and Exchange enrollment.

Medicaid and Exchange Enrollment Data Sources

Link to CMS Medicaid Expansion Enrollment Report:

“December 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report” (February 28, 2017)

Link to CMS Marketplace Open Enrollment Period Public Use Files:

“2017 Marketplace Open Enrollment Period Public Use Files” (March, 2017)

Table 3 – Medicaid/CHIP Enrollment Growth Across All States (September 2016), Final 2016 Exchange Enrollment (February 2016), and Preliminary 2017 Exchange Enrollment (December 10, 2016)