Medicaid Enrollment Skyrocketed During Pandemic

Martina Negron looks out a window as her home health aide Lidia Vilorio spends time cleaning, in Haverstraw, N.Y., on May 5, 2021. Michael M. Santiago/Getty Images

Enrollment in Medicaid grew by nearly 10 million during the COVID-19 pandemic, according to newly released data.

The number of people covered by the program, which helps poor people with healthcare bills, reached 73.7 million in January, according to the Centers for Medicare and Medicaid Services (CMS). That was up from 64 million 11 months prior, and a new record high.

Nearly one in four Americans have coverage from Medicaid or the Children’s Health Insurance Program. Combined, over 80 million were enrolled by the end of January, another unprecedented number.

CMS attributed the increase in enrollment to the COVID-19 relief package that Congress passed in March 2020 before President Donald Trump signed it into law.

The package, formally known as the Families First Coronavirus Response Act, provided states with a temporary payment increase in matching funding for Medicaid. In exchange, states were forbidden from removing people who later became ineligible for the program.

Every state saw an increase in enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) between November 2020 and December 2020, with 34 seeing a jump of 1 percent of more, according to the new CMS data (pdf). Kentucky was the only state that saw a decline, with a 0.5 percent drop.

Every state’s enrollment increased again between December 2020 and January, except for Alaska.

“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 now more than ever, we must work to strengthen Medicaid and make it available whenever and wherever it’s needed using the unprecedented investments Congress provided,” Health Secretary Xavier Becerra said in a statement.

Health Secretary Xavier Becerra testifies during a congressional hearing in Washington on June 10, 2021. Kevin Dietsch/Getty Images

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

The temporary funding in the relief package is contingent on the existence of a public emergency. Once that ends, states can adopt stricter formulas for accepting new applicants to Medicaid or people already receiving assistance.

Enrollment in both Medicaid and CHIP was declining for the two years before the pandemic, after rising following the passage of the Affordable Care Act, or Obamacare, according to the Kaiser Family Foundation.

During the pandemic, enrollment rose in every state, led by a 26 percent jump in Utah.

Analysts at the foundation say that enrollment may keep rising even as the economy continues to recover, since there is typically a lag between unemployment and enrollment growth.

Researchers said in a letter published in The Journal of the American Medical Association last month that the increase in enrollment was greater in states with smaller changes in unemployment last year, which they said may indicate that the growth was “associated with factors other than job loss, including reduced work hours making more people eligible, greater focus on health care during the pandemic, and the maintenance of effort requirement passed by Congress in March 2020, which offered states more funding in exchange for a requirement that they not disenroll anyone from Medicaid during the public health emergency.”

Millions of Americans were in danger of losing Medicaid coverage if the Supreme Court agreed with a collection of states that Obamacare is unconstitutional, but the nation’s top court ruled last week that plaintiffs lacked standing.