Medicaid & CHIP Eligibility - DEPARTMENT OF HEALTH AND...

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, MD 21244-1850 Medicaid & CHIP: July 2016 Monthly Applications, Eligibility Determinations and Enrollment Report September 27, 2016 Background This monthly report on state Medicaid and Children’s Health Insurance Program (CHIP) data represents state Medicaid and CHIP agencies’ eligibility activity for the calendar month of July 2016. This report measures eligibility and enrollment activity for the entire Medicaid and CHIP programs in all states 1 , reflecting activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, including states that have not yet chosen to adopt the new low-income adult group established by the Affordable Care Act. 2 This data is submitted to CMS by states using a common set of indicators designed to provide information to support program management and policy-making related to application, eligibility, and enrollment processes. 3 As with previous reports, this month’s report focuses on those indicators that relate to the Medicaid and CHIP application and enrollment process: 4 The number of applications submitted directly to Medicaid and CHIP agencies, including those received through State-Based Marketplaces (SBMs); The number of eligibility determinations made by Medicaid and CHIP agencies on the applications described above, as well as applications to the Federally-Facilitated Marketplace (FFM) in states for which the FFM makes an eligibility assessment (and the state then completes the Medicaid or CHIP determination); and The total number of individuals enrolled in the Medicaid and CHIP programs who are receiving comprehensive benefits, including details on the total number of children enrolled in these programs. 1 For purposes of this report, the term “states” include the 50 states and the District of Columbia. 2 As of July 2016, thirty-two states had implemented the expansion of Medicaid under the Affordable Care Act to cover adults under age 65 with incomes up to 133 percent of the Federal Poverty Level. Louisiana implemented its new Medicaid expansion, Healthy Louisiana, on July 1, 2016. The enrollment impact of the Medicaid expansion varies; some states expanded coverage to parents and other adults at income levels above the level required under federal law before the Affordable Care Act. Many other states previously covered parents only at the minimum required income levels and often did not cover other adults without disabilities or adults without dependent children who are under age 65 at all. 3 See Appendix A for the standardized data definitions for the data included in this report. States continue to transition to these standardized definitions. State-specific notes on the differences between state-reported data and the data definitions are included in the tables in this report.
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