Measuring Medicaid/CHIP Enrollment Progress Under the Affordable Care Act

An estimated 2.9 million Medicaid applications have not yet been processed by states.

As states work to clear these backlogs, it is useful to assess how well states have been doing in 2014 at enrolling people who are eligible for Medicaid and the Children’s Health Insurance Program (CHIP). The Centers for Medicare and Medicaid Services released information on how many additional people were enrolled in coverage through Medicaid and CHIP since October 1, 2013, when the first open-enrollment period for the new health insurance marketplaces was launched, through April 2014, the most recent information available.

This brief assesses how reported changes in enrollment in Medicaid and CHIP during this period compare with changes in Medicaid/CHIP enrollment projected by the end of 2016 by the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM).

Key Findings

  • As of April, 2014, Medicaid/CHIP programs had reached 47 percent of the Medicaid/CHIP enrollment increases projected to be obtained by the end of 2016.

  • Medicaid/CHIP enrollment is projected to increase by 12.8 million by 2016, of whom 9.9 million live in states expanding Medicaid and 2.9 million live in states not expanding Medicaid.

  • States that expanded Medicaid had reached 53 percent of the 2016 projected enrollment increases by April 2014 compared with a rate of 29 percent for states that did not expand Medicaid.

  • States vary tremendously in Medicaid/CHIP enrollment increases relative to projected increases, though reporting differences across states make interpretation of state-specific patterns within in each category challenging; it is anticipated that the quality and consistency of the enrollment statistics will improve over time.