Tracking Medicaid Enrollment Growth During COVID-19 Databook

Prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program

As much of the nation’s economic activity ground to a halt at the beginning of the COVID-19 pandemic, millions of people lost their jobs and many also lost their job-based healthcare coverage. The COVID-19-driven downturn triggered expectations that states would see substantial increases in Medicaid enrollment, leading to potentially significant fiscal pressures.

To address these pressures and protect coverage during the public health crisis, Congress passed legislation—the Families First Coronavirus Relief Act (FFCRA)—temporarily increasing the federal share of Medicaid funding. The increase in the Federal Medical Assistance Percentage (FMAP) under the FFCRA was tied to requirements that states not reduce Medicaid coverage through programmatic changes and not disenroll people from the program for the duration of the U.S. Department of Health & Human Services public health emergency. These requirements effectively eliminated churn in existing enrollment, but the pace and duration of new enrollment growth have been harder to predict. Given state budget constraints and the current stalemate in Congress with respect to the provision of additional FMAP relief, understanding the trajectory of Medicaid enrollment growth has become critically important for state Medicaid agencies.

In the “Tracking Medicaid Enrollment Growth During COVID-19 Databook,” produced in partnership with the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health partner Cindy Mann and manager Adam D. Striar provide a comprehensive, detailed look at 2020 Medicaid enrollment trends by state across four eligibility categories: expansion adults; children; non-expansion adults; and aged, blind and disabled individuals. Cindy and Adam also compare enrollment trends across expansion and non-expansion states.

As a companion to the Databook, they also authored an Overview that summarizes key findings from an analysis of the Databook.

To access the full Databook, click here.

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