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Pandemic, Mandates Drive 8.3% Enrollment Growth for Medicaid, CHIP

Analysis  |  By John Commins  
   December 21, 2020

CMS says enrollment growth is driven largely by the Public Health Emergency and the Families First Coronavirus Response Act's continuous enrollment mandate.

Medicaid and Children's Health Insurance Program enrollment grew by a combined 5.8 million people, or 8.3%, from February to August, a data "snapshot" from the Centers for Medicare & Medicaid Services shows.

Following months of decline in applications early in the public health emergency, the new data released Monday show an increase in applications starting in June, with a big leap in applications between July and August.

A further breakdown of the data shows that Medicaid enrollment grew by more than 5.8 million people, or 9.1%, over the seven-month span, and that CHIP enrollment grew by 33,000 children, or 0.5%.

CMS Administrator Seema Verma said the enrollment growth is driven largely by the COVID-19 Public Health Emergency, and by the Families First Coronavirus Response Act's continuous enrollment mandate.

"In the midst of a pandemic of generational scope and fury, it has never been more important to understand the underlying drivers of enrollment trends and the impact of new congressional requirements," Verma said.

The mandate provides a temporary 6.2% increase in matching funds through Federal Medical Assistance Percentages for states but requires states to maintain Medicaid enrollment for beneficiaries except in a few circumstances.

However, CMS noted that -- while the data on applications suggest that new enrollment has affected the overall increases in Medicaid and CHIP enrollment during the PHE -- it has not been "the key driver," because enrollment growth is outpacing applications.

"This trend suggests that enrollment increases are likely attributed to existing enrollees remaining eligible due to the maintenance of effort requirements," CMS said, adding that it will "continue to monitor these trends."

“In the midst of a pandemic of generational scope and fury, it has never been more important to understand the underlying drivers of enrollment trends and the impact of new congressional requirements.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

A further breakdown of the data shows that Medicaid enrollment grew by more than 5.8 million people, or 9.1%, over the seven-month span, and that CHIP enrollment grew by 33,000 children, or 0.5%.

The Families First Coronavirus Response Act's continuous enrollment mandate provides a temporary 6.2% increase in matching funds for states but requires states to maintain Medicaid enrollment for beneficiaries.

While the data on applications suggest that new enrollment has affected the overall increases in Medicaid and CHIP enrollment during the PHE, enrollment growth is outpacing applications because of the maintenance of coverage mandate.


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