Medicaid Enrollment Reaches Record High in the Wake of the Pandemic

On June 21, the Centers for Medicare & Medicaid Services (CMS), an agency inside the Department of Health and Human Services (HHS), published new statistics on enrollment in the Medicaid program and in the Children’s Health Insurance Program (CHIP), showing a record total enrollment in Medicaid and CHIP programs of 80,543,351, among the 50 states in the U.S. and the District of Columbia. That figure represents a 13.9-percent increase, with nearly 9.9 million individuals enrolling in coverage between February 2020 and January 2021. And more than 74 million are now enrolled in Medicaid specifically.

A press release posted to HHS’s website stated that, “Among the 50 states and the District of Columbia, a total of 80,543,351 people were enrolled and receiving full benefits from the Medicaid and CHIP programs by the end of January 2021. In the 50 states that reported total Medicaid child and CHIP enrollment data for January 2021, over 38.3 million children were enrolled in Medicaid and CHIP combined, approximately 50% of the total Medicaid and CHIP enrollment. These numbers highlight the essential role the Medicaid and CHIP programs play in providing quality and needed coverage for millions of vulnerable children and adults. In fact, both programs serve as the largest single source of health coverage in the country.”

And it quoted HHS Secretary Xavier Becerra as stating that "The Biden-Harris administration is using every lever to ensure any American needing access to quality health coverage receives it. Now more than ever, people need the peace of mind of knowing that they have health coverage. This report reminds us what a critical program and rock Medicaid continues to be in giving tens of millions of children and adults access to care,” Becerra said. “This pandemic taught us that now more than ever, we must work to strengthen Medicaid and make it available whenever and wherever it's needed using the unprecedented investments Congress provided."

“The increase in total Medicaid and CHIP enrollment,” the press release stated, “is largely attributed to the impact of the COVID-19 PHE, in particular, enactment of section 6008 of the Families First Coronavirus Response Act (FFCRA). FFCRA provides states with a temporary 6.2% payment increase in Federal Medical Assistance Percentage (FMAP) funding. States qualify for this enhanced funding by adhering to the Maintenance of Effort requirement, which ensures eligible people enrolled in Medicaid stay enrolled and covered during the PHE [Public Health Emergency].”

"Medicaid and CHIP serve as a much-needed lifeline for millions of people throughout this country. The increase we are seeing is exactly how Medicaid works: the program steps in to support people and their families when times are tough," CMS Administrator Chiquita Brooks-Lasure said, in a statement contained in the press release. "For the parents that may have lost a job or had another life change during the pandemic, having access to coverage for themselves and their kids is lifechanging. CMS is committed to ensuring our nation's marginalized communities and low-income families have the coverage they need."

The press release went on to state that, “To assist states and territories in their response to the COVID-19 PHE, CMS developed numerous strategies to support Medicaid and CHIP programs in times of crisis, including granting states more flexibility in their Medicaid and CHIP operations. Today's data release also reflects a range of indicators related to key application, eligibility, and enrollment processes from within state Medicaid and CHIP agencies.”

The Biden administration has committed to getting every state government to expand Medicaid in order to cover those in need, but 12 state legislatures have nevertheless chosen not to expand Medicaid in their states, while in two states (Missouri and Oklahoma), majorities of voters have supported ballot measures expanding Medicaid, but those states’ legislatures nevertheless have refused to expand the program (see this webpage that explains the status of Medicaid expansion, created by the Kaiser Family Foundation), under the terms laid out for Medicaid expansion under the Affordable Care Act (ACA).

A whitepaper published by the Kaiser Family Foundation on March 17 examines the impact of Medicaid expansion under the ACA, in the states in which the program has been expanded.