Continuous Eligibility And Coverage Policies Expanded Children's Medicaid Enrollment

Abstract

We examined children's Medicaid participation during 2019-21 and found that as of March 2021, states newly adopting continuous Medicaid coverage for children during the COVID-19 pandemic experienced a 4.62 percent relative increase in children's Medicaid participation compared to states with previous continuous eligibility policies.

Exhibit 1:. Adjusted Estimates of Increases in Child Medicaid Participation in New Continuous Coverage States Relative to Prior Continuous Eligibility States, March 2019-March 2021

Source: Medicaid participation data from March 2019-March 2021 were obtained from CMS Monthly Medicaid and CHIP Application, Eligibility Determination, and Enrollment Reports available at data.medicaid.gov. Prior continuous eligibility status was obtained from the Kaiser Family Foundation report, Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: Findings from a 50-State Survey (https://files.kff.org/attachment/Report-Medicaid-and-CHIP-Eligibility,-Enrollment-and-Cost-Sharing-Policies-as-of-January-2020.pdf). New continuous coverage status was ascertained based on authors’ analysis of the Families First Coronavirus Response Act. Notes: Prior continuous eligibility states are those that had adopted 12-month continuous eligibility policies for Medicaid-insured children ages 0 to 18 years through a state plan amendment as of January 2020. New continuous coverage states adopted continuous coverage for all beneficiaries, including children, pursuant to the March 2020 Families First Coronavirus Response Act. Arizona was excluded from this analysis due to lack of available monthly data on number of children enrolled in Medicaid.

Exhibit 3:. Unadjusted Trends in Children’s Medicaid Participation in Prior Continuous Eligibility States and New Continuous Coverage States, March 2019-March 2021

Source: Medicaid participation data from March 2019-March 2021 were obtained from CMS Monthly Medicaid and CHIP Application, Eligibility Determination, and Enrollment Reports available at data.medicaid.gov. Prior continuous eligibility status was obtained from the Kaiser Family Foundation report, Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: Findings from a 50-State Survey(https://files.kff.org/attachment/Report-Medicaid-and-CHIP-Eligibility,-Enrollment-and-Cost-Sharing-Policies-as-of-January-2020.pdf). New continuous coverage status was ascertained based on authors’ analysis of the Families First Coronavirus Response Act. Notes: This analysis includes 26 new continuous coverage states and territories and 24 prior continuous eligibility states. New continuous coverage and prior continuous eligibility are defined in the Exhibit 1 notes. Arizona was excluded from the analysis due to lack of available monthly data on number of children enrolled in Medicaid.

Exhibit 4:. Increases in Children’s Medicaid Enrollment, by State Prior Continuous Eligibility and New Continuous Coverage Status, March 2020-March 2021

Source: Prior continuous eligibility status was obtained from the Kaiser Family Foundation report, Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: Findings from a 50-State Survey (https://files.kff.org/attachment/Report-Medicaid-and-CHIP-Eligibility,-Enrollment-and-Cost-Sharing-Policies-as-of-January-2020.pdf). New continuous coverage status was ascertained based on authors’ analysis of the Families First Coronavirus Response Act. Medicaid enrollment data from March 2020-March 2021 were obtained from CMS Monthly Medicaid and CHIP Application, Eligibility Determination, and Enrollment Reports available at data.medicaid.gov. Notes: States shown without hatch marks are prior continuous eligibility states. See Exhibit 1 notes for definitions of prior continuous eligibility and new continuous coverage states. Arizona was excluded from this analysis due to lack of available monthly data on number of children enrolled in Medicaid.