Recently there have been declines in Medicaid and CHIP enrollment, reversing a previous trend of increases following implementation of the ACA. Administrative data from the Centers for Medicare & Medicaid Services (CMS) show that total Medicaid and CHIP enrollment declined by 2.4 million, from 74.6 million enrollees in December 2017 to 72. million enrollees in June 2019. Some of this decline may reflect people moving to other coverage due to the improving economy, as noted by the Trump administration and some state officials. However, survey data show that the uninsured rate increased from 7.9% to 8.5% between 2017 and 2018, driven by decreases in Medicaid and CHIP coverage. Moreover, experiences in some states suggest that renewal process requirements and growing use of periodic eligibility checks may be contributing to disenrollment among people who are still eligible for coverage as well as increased churn in coverage. This brief reviews current rules and state processes related to renewal and periodic eligibility reviews and discusses potential process issues that may be contributing to Medicaid and CHIP enrollment declines.
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