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Taking a closer look at the numbers involving Medicaid enrollments, it’s easy to see that the pandemic continues to have an effect on Americans economically. We saw unprecedented job losses and furloughs, which in our world translates to lost health insurance coverage. For those businesses serving the health insurance industry, from the exchanges to private providers, this influx of applicants continues to force interface improvements. And as we head into the second quarter, the experts are predicting even more Medicaid enrollments to surge.

Medicaid Coverage as the Only Solution for Many

Several data models began predicting surges in Medicaid enrollment earlier last year. While most models can try to put a figure on how many Americans actually lost their jobs during COVID-19 shutdowns, the number of those who eventually found health insurance coverage is still officially undetermined. Health Affairs surveyed enrollment reports from March 1st through June 1st of last year and across 26 different states. Their findings indicate Medicaid provided coverage for more than 1.7 million people during that period. Each state may have different trajectories in terms of enrollment growth and lag time between job loss and enrollment, but overall, the data points to state policies in direct response to the pandemic as a contributing factor.

Medicaid coverage is always a critical option for those experiencing economic hardships. It’s even more evident now that more Americans are finding themselves in low-income brackets due to the shuttering economy and the pandemic policies. And while it often served the needs of children, over time, Medicaid is a primary source of health coverage for many adults, as well. Even as some Americans try to venture back to work or find new paths to employment, Medicaid continues to see increased enrollment in many data models.

What the CMS Monthly Enrollment Snapshot Reveals

The Centers for Medicare and Medicaid Services shared the first monthly Medicaid and CHIP enrollment data last September. This first look intended to show the impacts of the virus on enrollment trends. More than four million new Medicaid individuals enrolled between February and June of last year, a sharp increase of more than five percent since the pandemic first hit that previous March. CHIP enrollment rose by 23,495. CMS uses performance indicators to analyze this data, including applications, number of eligibility determinations, renewals, and official enrollment numbers.

What We Learned About Medicaid During the Recession of 2008

Trying to project Medicaid enrollment numbers might be better served by taking a look back. The recession of 2008 and 2009 provides insights and reinforces just how important Medicaid really is in times of financial trouble. Within the 2007 and 2009 timeframe, non-elderly adult enrollment jumped 1.3 percent. The number of children covered through the Children’s Health Insurance Program surged 4.8 percent. The unemployment rates for those times were up from the five percent in December of 2007 to 9.5 percent by January of 2009.

Of course, the recession back then is much different than the COVID-stricken economy of today. But the patterns are similar. The big difference in today’s environment from the recession is the job loss and unemployment rates. We’re already seeing much higher numbers today. Also, the recession preceded the Affordable Care Act and the Medicaid expansion efforts. A final differentiating factor in today’s economy lies within some states’ inability to disenroll participants in Medicaid unless and until the federal health emergency declaration ends. It’s this declaration that is allowing Medicaid to receive additional funding right now.

Pandemic Unemployment Numbers

It’s hard to put an accurate number of Americans currently or previously on unemployment benefits as a direct result of the pandemic. However, the more than 30 million initial insurance claims filed between March and June of last year can give you an idea. The official national unemployment rate jumped from 3.5 percent last February to 13.3 percent by last May. Now, as far as health insurance coverage goes, those stats can be even harder to track. Some who lost employer-based coverage were able to enroll with a household member’s plan. Others fell into special enrollment periods, allowing them to find coverage via the exchanges. But there are a substantial number of households and families who found coverage solutions with Medicaid due to their new low-income status changes as a result of job losses and layoffs. Federal Medicaid enrollment figures aren’t available yet for this period; however, some state Medicaid agencies are updating their numbers, demonstrating massive increases in Medicaid enrollment since the beginning of the pandemic shutdowns.

The Lag Between Unemployment and Medicaid Enrollment

The Kaiser Family Foundation points out that each state’s pandemic-affected economy timelines are different. Some saw more economic trouble earlier last year, while others are still financially reeling from its effects. There is some preliminary data supporting the notion, however, that Medicaid enrollment is skyrocketing right now. Total enrollment increased by more than six million in September to hit 77.3 million Americans. Medicaid enrollment is, of course, based on low-income eligibility. This eligibility can sometimes lag behind the catalyst for financial hardship. People lose their jobs and may sustain for a few weeks or longer before eventually applying for and qualifying for Medicaid assistance. This may be an indication that as various states still combat the pandemic with shuttered economies, there could be even higher surges in Medicaid enrollment down the road. And again, until the federal emergency declaration comes to an end, states will continue to rely on Medicaid funding to enroll eligible individuals.

While Medicaid continues to expand and see increased enrollments, is your business platform ready? If you need help managing the new requirements, including the new 1115 and 1332 Waivers, contact us! We can help you explore your options and leverage our Verify Enhanced Eligibility solutions.

We’re experts in CMS and state MMIS eligibility systems and can help you develop or improve your vertically integrated platform. Whether you’re exploring options for built-in compliance or just need guidance with configurable rules, you can benefit from a partnership with Softheon to help see you through this surge in Medicaid enrollment and pandemic after-effects.