Following the implementation of the Affordable Care Act (ACA) Medicaid expansion to low-income adults in 2014, there were large increases in Medicaid and CHIP enrollment across states that build on steady progress covering children over the past decade. These increases reflected enrollment among newly eligible adults in states that implemented the expansion as well as enrollment among previously eligible adults and children due to enhanced outreach and enrollment efforts and simplified enrollment procedures associated with the ACA. However, in 2018, enrollment declined by 1.6 million individuals, reversing this trend and raising questions about whether individuals losing Medicaid and CHIP coverage are becoming uninsured or transitioning to other coverage.
This fact sheet provides analysis of this recent enrollment decrease and discusses potential implications for coverage rates. It is based on Kaiser Family Foundation analysis of the Centers for Medicare and Medicaid Services (CMS) Performance Indicator Project Data.1 The enrollment counts include full-benefit individuals of all ages enrolled in Medicaid and CHIP for each month, including those with retroactive, conditional, and presumptive eligibility.
Date: May 29, 2019