Friday, October 02, 2020

Medicaid enrollment (likely) up 9% since February

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As my post tracking pandemic Medicaid enrollment through August has gotten rather clotted with updates, I've posted the totals afresh below.

The big addition is California. The state has adjusted its August tally to a slight increase, in line with those of prior months, which have also been adjusted.  I am using the raw totals from the state database of certified eligibles. California's adjusted totals show a slightly bigger increase than previously, but still well below national averages, a mystery examined here. Adding California pulls down the 32-state increase from February through August by 1.7 percentage points.

For context and discussion of some data issues, such as how I reconcile states that report monthly totals  as of the beginning or end of each month, please see the prior post. In particular, the most recent update at the top of that post explains the basis of my estimate that Medicaid enrollment nationally is somewhere between 77.3 million and 77.6 million as of August, based on what's now a 32-state sample below. 

In brief, the 51-state enrollment increase from February thru August is probably about 9%. Nationally, Medicaid enrollment is now about 37% higher than it was in the third quarter of 2013, the pre-ACA point of comparison.

As the chart text was getting rather small, I've removed columns providing info about the programs each state tracks and the extent to which their tracking matches CMS's. See note, and chart with those columns retained, at bottom.

Pandemic Medicaid Enrollment in 32 States (updated 10/1)
February through August 2020
Expansion states in blue; nonexpansion states in red; Medicaid to 100% FPL in purple
Totals as of the end of each month
Estimated August totals in green

I have estimated August increases for two states, Illinois and New Hampshire that have reported through July only. For the estimate, I attributed the increase from June-July to July-August. As reflected above, the all-state increase in those two month periods was nearly identical. Any error in those estimates is likely to amount to less than a tenth of a percentage point for the 32-state total. [Update, 10/5: New Hampshire has reported. The estimate overshot by 400 - still visible below.]

A note on state tracking: In their monthly Medicaid reports, some states include programs excluded in CMS's national tracking, such as those the state funds entirely on its own dime. In other cases, CMS includes programs that the states exclude. Several states track enrollment in Medicaid managed care plans only, leaving out fee-for-service Medicaid. The second and last columns in the chart below (otherwise identical to the chart at top) reflect these differences.

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