This week, our In Focus section reviews updated information issued by the Department of Health & Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on Medicaid expansion enrollment from the “May 2017 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report,” published on July 21, 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 in the first half of 2017, representing nearly 75 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 74.5 million individuals as of May 2017.
- Medicaid and CHIP enrollment is up more than 2 million members since Spring 2016, a 3 percent increase in enrollment.
- Since Spring 2016, five states saw double-digit percentage growth in Medicaid and CHIP – Louisiana (35.6 percent); Alaska (29.3 percent); Florida (20.9 percent); Montana (12.8 percent); and North Dakota (11.3 percent). Three of these states, Louisiana, Alaska, and Montana, were the most recent states to adopt Medicaid expansion: Alaska on September 1, 2015, Montana on January 1, 2016, and Louisiana on July 1, 2016.
- Over that same period 17 sates saw a net decline in enrollment over Medicaid and CHIP, and an additional three states saw enrollment growth of less than 1 percent.
- As of May 2017, national Medicaid and CHIP enrollment is up nearly 16.8 million (nearly 30 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 (106.3 percent), Nevada (89.9 percent), Colorado (79.6 percent), Montana (72.4 percent) and New Mexico (70.7 percent). All five are Medicaid expansion states.
- The top five states in percentage growth of Medicaid and CHIP among states that did not expand Medicaid are North Carolina (27.3 percent), Idaho (24 percent), Tennessee (22.7 percent), Florida (17.7 percent), and Missouri (15.3 percent).
- The top five states in total enrollment growth of Medicaid and CHIP are California (4.5 million), New York (754,600), Washington (686,900), Florida (653,500), and Kentucky (644,900).
Table 1 – Overall U.S. Medicaid/CHIP Enrollment Growth – Pre-Open Enrollment Monthly Average through May 2017
Key Takeaways from 2017 Exchange Enrollment Report
- Final Exchange enrollments for the 2017 plan year, published in March 2017, showed that Qualified Health Plan (QHP) plans have been selected by more than 12.2 million individuals 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.
- Despite the aggregate national decreased, 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 in the data package below provides state-level data on Medicaid and Exchange enrollment.
Medicaid and Exchange Enrollment Data Sources
Link to CMS Medicaid Expansion Enrollment Report:
Link to CMS Marketplace Open Enrollment Period Public Use Files:
“2017 Marketplace Open Enrollment Period Public Use Files” (March, 2017)