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Unwinding and Returning to Regular Operations after COVID-19
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Related Links
- Data Overview: Medicaid and CHIP Renewals and Returning to Regular Operations
- Medicaid and CHIP Enrollment Data
- Medicaid and CHIP Enrollment Highlights
View the complete CAA, 2023 reporting metrics dataset: Data.Medicaid.gov
Data Reporting
Medicaid and CHIP Renewals: Returning to Regular Operations
States across the country are resuming their regular processes for renewing individuals’ Medicaid and Children’s Health Insurance Program (CHIP) coverage. As this happens, our goal is to help people who are still eligible for Medicaid and CHIP to keep their coverage and help those who are no longer eligible transition to Medicare, employer-sponsored coverage, or Marketplace plans.
Data from Medicaid and CHIP renewals show how states are resuming regular eligibility operations following the end of the Medicaid continuous enrollment condition authorized by the Families First Coronavirus Response Act. The Consolidated Appropriations Act, 2023 (CAA, 2023) requires state monthly reporting about activities related to eligibility renewals, call center operations, and transitions to Marketplace coverage, from April 1, 2023, through June 30, 2024. CMS is also providing information such as changes in Medicaid, CHIP and Marketplace enrollment; state operational data; and additional renewal metrics.
To dive straight into the data, please click through the menu on the left-hand navigation bar.
Historical Health Coverage Changes
The Medicaid and CHIP programs provided essential health coverage to millions of people during the COVID-19 public health emergency.
The data below show where people in the U.S. got their health coverage before the Medicaid continuous enrollment condition took effect and before it ended. A significant share of these individuals is counted in more than one category — for example, in February 2023, more than 12 million people had both Medicaid and Medicare coverage, and in 2021, 15% of Medicaid enrollees ages 19-64 also had employer-sponsored coverage (where Medicaid is the payer of last resort).1
Data will be updated as it becomes available. For some data sources, there is a lag of several months.
Pre-Pandemic and Pre-Renewal U.S. Health Coverage: February 2020 and February 2023 (numbers in the millions) | ||
February 2020 | February 2023 | |
US Total Population | 329 | 334 |
Enrolled in Medicaid and CHIP | 71 | 93 |
Enrolled in Marketplace | 11 | 16 |
Enrolled in Medicare | 62 | 66 |
Dual Enrollment | 11* | 12** |
Enrolled in Employer Sponsored Coverage | 179 | 178 |
Uninsured | 32 | 27 |
**2021 annual enrollment (full and partial dual enrollment)
Note that totals may not sum exactly due to rounding and multiple forms of coverage. Analysis completed by the Assistant Secretary for Planning and Evaluation.
Sources: https://www.census.gov/data/tables/time-series/demo/popest/2020s-national-total.html
https://www.census.gov/data/tables/time-series/demo/popest/2010s-national-total.html)
https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot/index.html
https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment
https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/cms-program-statistics-medicare-medicaid-dual-enrollment
As noted above, before the continuous enrollment condition took effect, people frequently transitioned coverage. Typically, about 17 million people disenroll from Medicaid or CHIP coverage each year. Some disenroll from coverage because they’re no longer eligible; others because of errors, such as not returning the required paperwork on time. Our goal is to help people who are still eligible for Medicaid and CHIP to keep their coverage and help those who are no longer eligible transition to another source of coverage.
The data below provide an overview of where people leaving Medicaid and CHIP sought coverage in 2018 and 2019.2 This helps inform CMS and state efforts to help people transitioning out of Medicaid or CHIP to new coverage and serves as a baseline to understand how current efforts will compare to historic trends.
What Happened to People Who Left Medicaid and CHIP in HealthCare.gov States: Jan 2018 - Dec 2019 | |
Returned to Medicaid/CHIP Same State | 29% |
Returned to Medicaid/CHIP Different State | 8% |
Transitioned to Medicare | 7% |
Transitioned to Marketplace | 4% |
Died | 6% |
Other (e.g., Employer Coverage, Uninsured) | 49% |
Notes: Excludes NV, which transitioned to a state-based Marketplace in 2020.
These enrollment counts include Medicaid and CHIP beneficiaries with full and partial benefits, as well as those dually eligible for Medicaid and Medicare. Transitions are limited to those that occurred within 12 months after the Medicaid/CHIP coverage loss date.
Percentages will not sum to 100%; beneficiaries can transition to multiple forms of coverage. For consumers with more than one Medicaid/CHIP leaving event from January 2018 - December 2019, the latest event is used.
CMS Data Release Timeline
CMS expects to release data on a monthly basis, with monthly releases expected to continue until all data is reported for months through June 2024. Full data on individuals who are transitioning from Medicaid and CHIP to Marketplace coverage is expected to be available beginning in fall 2023.
CMS will consolidate data from multiple data sources. Given differences in availability of different data sources, CMS will release each month’s data in two releases. The first release will reflect renewal outcomes, call center operations, and initial transitions to Marketplace coverage. The second release will focus on transitions of coverage for people who left Medicaid or CHIP in HealthCare.gov states and will follow two months after the initial release.
Snapshot of May 2023 Data
States have taken different approaches to resuming the regular Medicaid and CHIP renewal process. Some states started renewals with individuals they think are unlikely to be eligible, while other states began conducting renewals for their general populations. Some states have also started the renewal process sooner than others. Read more about 2023 state timelines for initiating renewals.
While some data won’t be available until later in the process, CMS is able to report on renewals and early data from the Marketplaces.
National Summary of Outcomes of Medicaid and CHIP Renewals Due May 2023
For 36 states reporting at least one full cohort of unwinding-related renewals in May 2023 | Percent of beneficiaries due for renewal in the reporting month |
Total Renewals Due in May 2023 (based on states’ distribution of renewals) | 4.0 million |
Coverage Renewed | 42.1% |
Automatic renewal (“ex parte”) | 24.7% (58.7% of total renewals) |
Determined eligible | 17.4% (41.3% of total renewals) |
Coverage Terminated | 37.6% |
Determined ineligible | 8.6% (22.8% of total terminations) |
Procedural terminations | 29.0% (77.2% of total terminations) |
Renewals Pending - To be Completed | 20.3% |
Marketplace Enrollments, for May 2023 | |
HealthCare.gov Consumers with Previous Medicaid or CHIP Enrollment with a QHP Selection | 107,000 |
State-Based Marketplace Consumers with a Medicaid/CHIP Denial or Termination with a QHP Selection | 17,000 |
View the complete CAA, 2023 reporting metrics dataset on Data.Medicaid.Gov
1. Lee, Aiden et. al., “Medicaid Enrollees Who are Employed: Implications for Unwinding the Medicaid Continuous Enrollment Provision,” U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, April 2023, https://aspe.hhs.gov/sites/default/files/documents/779b6ef3fbb6b644cdf859e4cb0cedc6/medicaid-esi-unwinding.pdf.
2. These data are only from states with Marketplaces that use the HealthCare.gov platform, as opposed to a state-based Marketplace that uses its own platform.