Enrollment

On March 27, the Centers for Medicare & Medicaid Services (CMS) released the “Streamlining Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” (CMS-2421-F2) final rule. The rule is designed to make it easier for millions of eligible people to enroll in and retain their Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) coverage.

This KFF policy watch examines three key questions to monitor as states navigate the unwinding of the Medicaid continuous enrollment provision initiated during the COVID-19 public health emergency. Examining changes in Medicaid enrollment, the report notes a nearly 10% decline in Medicaid enrollment nationally, with significant state-level variations. As states progress through renewals, the article emphasizes the unpredictable trajectory of Medicaid enrollment at the process's conclusion, acknowledging the potential return to pre-pandemic levels. Confronting challenges posed by procedural disenrollments and new enrollments, the report explores the implications for Medicaid participation and broader trends in healthcare coverage...

KFF released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on May 10. This tracker provides state-level data on Medicaid/CHIP enrollment, unwinding, renewals, and other measures. Please note that while the tool includes national data reported by CMS, it has a lag of several months and may not reflect the most current Medicaid enrollment status.

The Centers for Medicare & Medicaid Services (CMS) released the final national snapshot for the 2024 Marketplace Open Enrollment (OEP), reporting that 21.3 million consumers have signed up for 2024 individual market health insurance coverage through the Marketplaces since the start of the 2024 OEP on November 1. This includes 16.4 million Marketplace plan selections in the 32 states using the HealthCare.gov platform for the 2024 plan year through the end of the OEP on January 16, 2024 (Week 11+), and 4.9 million plan selections in the 18 states and the District of Columbia with State-based Marketplaces (SBMs) that are using their own eligibility and enrollment platforms, through January 13, 2024 (Week 11) or the end of their OEP...

KFF recently released a policy watch titled “What Are the Implications of the Recent Elimination of the Medicaid Prescription Drug Rebate Cap?” As of January 1, 2024, the American Rescue Plan Act (ARPA) lifted the cap on the total amount of rebates that Medicaid could collect from manufacturers who raise drug prices substantially over time. Anticipating the implementation of this policy, drug manufacturers have made various changes allowing them to avoid increased rebates resulting from the lifting of the cap. Recent changes that have garnered attention include price cuts for insulin, used to treat diabetes, and the discontinuation of Flovent, a frequently used asthma inhaler....

The Centers for Medicare & Medicaid Services (CMS) reports that over 20 million Americans have signed up for 2024 individual market health insurance coverage through the Marketplaces since the start of the 2024 Marketplace Open Enrollment Period (OEP) on November 1. This includes 15.5 million Marketplace plan selections in the 32 states using the HealthCare.gov platform for the 2024 plan year and 4.8 million plan selections in the 18 states and the District of Columbia with state-based Marketplaces (SBMs) that are using their own eligibility and enrollment platforms, through December 23, 2023 (Week 8). Total nationwide plan selections include 3.7 million consumers (18% of total) who are new to the Marketplaces for 2024...

KFF released an updated version of their "Medicaid Enrollment and Unwinding Tracker" on February 1. This tracker provides state-level data on Medicaid/CHIP enrollment, unwinding, renewals, and other measures. Please note that while the tool includes national data reported by CMS, it has a lag of several months and may not reflect the most current Medicaid enrollment status.

The Centers for Medicare & Medicaid Services released their monthly report for November 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

The Centers for Medicare & Medicaid Services released their monthly report for October 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

This report presents information on managed care’s enrollment and spending. It explores the growth of enrollment in Medicaid Managed Care in the United States and the contributing factors. It also analyzes the fact that funding does not directly parallel enrollment, as the share of total Medicaid spending that went to managed care only grew from 15 percent to 37 percent between 1999 and 2012, despite enrollment growing from 63 percent to 89 percent during that same time period.