COVID-19 caused increased enrollment in Medicaid and CHIP, CMS says

Photo: Marko Geber/Getty Images

According to a new enrollment trends snapshot released this week by the Centers for Medicare and Medicaid Services, more than 80 million people have signed up for health coverage through Medicaid and the Children's Health Insurance Program, a record high.

Between February 2020 and January 2021 there was a 13.9% increase in people who enrolled in coverage, representing about 9.9 million people. That means the increases were seen over the course of the public health emergency caused by the COVID-19 pandemic.

Among the 50 states and Washington D.C., 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, more than 38.3 million children were enrolled in Medicaid and CHIP combined – about 50% of the total Medicaid and CHIP enrollment.

WHAT'S THE IMPACT?

CMS attributes the increase in total Medicaid and CHIP enrollment to the impact of the pandemic, 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.

In an effort to assist states and territories in their response to the pandemic, CMS developed strategies to support the programs in times of crisis, including granting states more flexibility in their Medicaid and CHIP operations. The data also reflects a range of indicators related to key application, eligibility and enrollment processes from within state Medicaid and CHIP agencies.

The snapshot is a product of the Centers for Medicare and Medicaid CHIP Services (CMCS) Medicaid and CHIP Coverage Learning Collaborative (MACLC), which monitors Medicaid and CHIP enrollment trends, primarily using the CMS Performance Indicator (PI) data reported to CMS by state Medicaid and CHIP agencies. PI data reflects key Medicaid and CHIP business processes, including applications, renewals, eligibility determinations and enrollment.

THE LARGER TREND

In February, a letter sent to governors by the Department of Health and Human Services stated that the current public health emergency caused by COVID-19 will likely last until the end of the year. With that extension, many of the flexibilities provided to states and hospitals at the start of the pandemic will continue.

Because of the extension, the expanded use of telemedicine, certain waivers to Medicare, Medicaid, CHIP and the Health Insurance Portability and Accountability Act Privacy Rule requirements, as well as the 6.2% increase in the Federal Medical Assistance Percentage, will remain in place. Additionally, the public health extension will allow hospitals to continue to receive a 20% Medicare add-on payment for patients who test positive for COVID-19.

The Federal Medical Assistance Percentage extension means states will be incentivized to maintain Medicaid funding and coverage as a way to receive the additional funds, which would result in fewer uninsured patients and more government reimbursements to hospitals, according to Moody's Investors Service.

ON THE RECORD

"The Biden-Harris administration is using every lever to ensure any American needing access to quality health coverage receives it," said HHS Secretary Xavier Becerra. "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. This pandemic taught us that ... we must work to strengthen Medicaid and make it available, whenever and wherever it's needed, using the unprecedented investments Congress provided."

"Medicaid and CHIP serve as a much-needed lifeline for millions of people throughout this country," said CMS Administrator Chiquita Brooks-LaSure. "The increase we are seeing is exactly how Medicaid works: The program steps in to support people and their families when times are tough.

"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 life-changing. CMS is committed to ensuring our nation's marginalized communities and low-income families have the coverage they need."
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com