Medicaid, CHIP enrollment decline for 2nd straight year 

Dollar bill with a hole in Washington's face on it and the word "Medicaid" in its place
MACPAC has released its annual look at Medicaid and CHIP enrollment and spending. (zimmytws/GettyImages)

Enrollment in Medicaid and the Children's Health Insurance Program (CHIP) declined nationally for the second year in a row, with a 2.6% decrease over the past two years, according to a new report. 

The Medicaid and CHIP Payment and Access Commission (MACPAC) released its annual look at enrollment, spending, benefits and service use for Medicaid and CHIP. The group found that Medicaid and CHIP enrollment dropped in 34 states and the District of Columbia. 

This trend was felt in both states that expanded Medicaid and those that did not. In California, for example, Medicaid enrollment declined by 2.6%, while in Missouri, a non-expansion state, enrollment dropped by 10.9%. 

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RELATED: Medicaid enrollment down in 2019 and expected to be flat in 2020, KFF says 

The report also found that 40% of people enrolled in Medicaid and CHIP had incomes below 100% of the federal poverty level. Nearly 60% earned less than 138% of the poverty level. 

In addition, MACPAC’s analysts found that Medicaid and CHIP were responsible for 17% of national health expenditures in 2017, behind Medicare (20%) and private insurance coverage (34%). 

The programs also took a similar chunk out of state budgets that year, accounting for 28.9% of the budget when both federal and state funds were included, or 19.7% of states’ general revenue on average. 

Medicaid beneficiaries accounted for 36% of overall spending nationally on home health services, 30% of spending on nursing homes or retirement communities and 57.8% of spending on other residential and health services, such as nursing care for people with mental disabilities and ambulance fees.