New data show Medicaid and CHIP enrollment decreasing for the first time since 2019 following the end of the continuous coverage provision
The Medicaid and CHIP Payment and Access Commission (MACPAC) today released the 2024 edition of the MACStats: Medicaid and CHIP Data Book, with updated data on national and state Medicaid and State Children’s Health Insurance Program (CHIP) enrollment, spending, benefits, beneficiaries’ health, service use, and access to care. Medicaid and CHIP covered more than 32 percent of the U.S. population in 2023 (Exhibit 1). About 39 percent of children had Medicaid or CHIP coverage in 2023 (Exhibit 2).
As of July 2024, 79.6 million people were enrolled in Medicaid and CHIP. Enrollment decreased by 13.7 percent from July 2023 to July 2024 as states began to redetermine beneficiaries’ eligibility following the end of the continuous coverage provision. Congress introduced continuous coverage in the Families First Coronavirus Response Act (FFCRA, P.L. 116-127), which states could adopt in return for enhanced federal funding (Exhibit 11).
MACStats offers the latest data on Medicaid and CHIP, two critical programs that serve as a safety net for low-income individuals who would otherwise lack access to comprehensive health care coverage. These programs also cover services that are frequently not provided by other payers. The data book provides context to help understand how Medicaid and CHIP fit into the broader health care system.
“The 2024 MACStats report offers invaluable insights into the evolving landscape of Medicaid and CHIP,” said MACPAC Chair Verlon Johnson. “This resource equips policymakers and researchers with the data needed to drive informed decisions to help strengthen access and improve outcomes for Medicaid and CHIP beneficiaries.”
Total Medicaid spending was $900.3 billion in fiscal year (FY) 2023 (Exhibit 16). Spending for CHIP was $23.4 billion (Exhibit 33). The increase in Medicaid spending for FY 2023 was driven almost equally by increases in enrollment and spending per full-year equivalent enrollee (Exhibit 10). However, Medicaid spending still represents a smaller share of the federal budget (10.0 percent) compared to Medicare (13.7 percent) (Exhibit 4). In FY 2022, individuals eligible on the basis of disability and enrollees age 65 and older accounted for about 20 percent of Medicaid enrollees but about 51 percent of program spending (Exhibits 14 and 21). Many of these individuals were users of long-term services and supports.
More highlights from this year’s edition of MACStats include:
- Spending for people who are dually eligible for Medicaid and Medicare accounted for more than $244 billion in spending in FY 2022 (Exhibit 21).
- More than half of Medicaid spending for enrollees was for capitation payments to managed care plans (Exhibits 17 and 18).
- Medicaid and CHIP enrollees of all ages were more likely to be persons of color and to report fair or poor health than individuals who were covered by private insurance (Exhibit 2).
- Over half of Medicaid spending for enrollees was for capitation payments to managed care plans (Exhibits 17 and 18).
- Children whose primary coverage source is Medicaid or CHIP are as likely to report seeing a doctor or having a wellness visit within the past year as those with private coverage and more likely than those who are uninsured (Exhibit 40).
Visit this link for the PDF and spreadsheet versions of the December 2024 MACStats: Medicaid and CHIP Data Book.
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ABOUT MACPAC
The Medicaid and CHIP Payment and Access Commission is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP). For more information, please visit: www.macpac.gov.
