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Medicaid, CHIP Enrollment Rose 600,000 in June, CMS Says

By John Reichard, CQ HealthBeat Editor

August 8, 2014 -- Enrollment in Medicaid and the Children's Health Insurance Program (CHIP) is continuing to steadily grow under the health law, with an added 602,210 people signing up in June, federal officials said last week.

The increase is based on preliminary data. About 7.2 million more people have signed up in the two programs since the Oct. 1 start of the law's initial open enrollment period last fall, said Cindy Mann, the top Medicaid official at the Centers for Medicare and Medicaid Services (CMS).

"Because enrollment in these programs can happen year-round, our latest report shows that number is still growing," Mann wrote in a blog post.

In announcing May sign-up figures last month, CMS said enrollment in the two programs had increased by 6.7 million.

The health law (PL 111-148, PL 111-152) relies on expanded eligibility for Medicaid and subsidized private insurance as the means to extend medical coverage to most Americans. As of June, 25 states and the District of Columbia have expanded their Medicaid programs.

Mann wrote that enrollment in states that expanded Medicaid eligibility has risen by 18.5 percent since before open enrollment began but by only 4 percent in states that kept the status quo.

"If the remaining 24 states accept federal funding to cover low-income adults in Medicaid, 5.7 million more low-income Americans could have access to affordable, quality care," she wrote. The latest tally does not include figures for Maine and North Dakota, which did not submit enrollment data for June or May, according to CMS.

A 26th state, New Hampshire, expanded its Medicaid eligibility effective July 1, with coverage kicking in Aug. 15. An expansion in Michigan that took effect April yielded 12.6 percent enrollment growth in the first three months of expanded eligibility, CMS said.

Nine of the states whose expansions were in effect as of June reported increases of 30 percent or more over the Oct. 1 start of open enrollment.

The health law actually began having an impact on Medicaid and CHIP enrollment well before the first open enrollment period began.

The law gave states the option of expanding Medicaid coverage for adults starting April 1, 2010. Seven states exercised that early option and nearly 950,000 people gained coverage as a result.

State and federal lawmakers opposed to the Medicaid expansion say the program offers low quality care. They also say the Medicaid entitlement threatens future generations with unsustainable levels of federal debt.

But states that haven't expanded face near term economic pressure to do so.

A study released late last week by the Urban Institute says those states are foregoing $423.6 billion in federal Medicaid funds from 2013 to 2022, lessening economic activity and job growth. The study estimated hospitals in the states are also losing $167.8 billion in Medicaid revenue that would come from larger caseloads.

"Every comprehensive state-level fiscal analysis that we could find concluded that expansion helps state budgets, generating savings and revenues that exceed increased Medicaid costs" to the states, the Urban Institute study stated.

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