Enrollment

State Medicaid unwinding data show procedural disenrollment rates are high across most states. This policy watch provides insights for interpreting the data and describes steps the Centers for Medicare and Medicaid Services (CMS) and states are taking to reduce procedural disenrollments. 

Enhanced Marketplace subsidies have continued to drive up enrollment in the individual market, and the loss of Medicaid coverage by millions of people could contribute to this trend, according to a new KFF analysis. Meanwhile, enrollment in non-ACA-compliant plans is at a record low. As of early 2023, an estimated…

This analysis looks at how many people are signed up for each type of individual ACA Marketplace coverage—both on- and off-Marketplace and with or without subsidies—as of early 2023 based on federal enrollment data and administrative data insurers report to state regulators, as compiled by Mark Farrah Associates. The number of people enrolled in compliant and non-compliant plans was also evaluated.

Some states are prioritizing Medicaid renewals for enrollees flagged as likely to be ineligible. Early data from Arizona, Idaho, and Pennsylvania show disenrollment rates for flagged enrollees are higher than for other enrollees. This analysis considers why different state approaches to renewals may explain some – but not all – variation in disenrollment rates across the U.S.

This brief takes a closer look at the five largest publicly traded companies operating Medicaid MCOs which account for half of Medicaid MCO enrollment nationally. Information and data reported in this brief come from quarterly company earnings reports, financial filings, and other company materials as well as from national administrative data.

Medicaid enrollment increased since the start of the pandemic, primarily due to the continuous enrollment provision. KFF estimates that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision. The Medicaid continuous enrollment provision stopped “churn” among Medicaid enrollees. States approaches…

As states begin to unwind the COVID emergency continuous enrollment provision and resume Medicaid disenrollments, early data from a handful of states – highlighted on KFF’s regularly-updated Medicaid Enrollment and Unwinding Tracker — reveal wide variation in disenrollment rates.

A KFF survey of Medicaid enrollees largely fielded prior to states resuming their efforts to redetermine Medicaid enrollees’ eligibility reveals many enrollees are unprepared for the renewal process that could result in some losing their coverage either due to eligibility changes or paperwork issues. During the COVID-19 pandemic, states suspended…

This brief gauges Medicaid enrollees’ knowledge of the Medicaid renewal process and possible disenrollment, following the end of continuous enrollment on March 31, 2023.

The unwinding of the continuous enrollment provision will play out differently across the states based on policy choices states have made and variation in their administrative infrastructures. Some states have adopted multiple policies that are more likely to promote continued coverage among those who remain eligible.