Medicaid and Children’s Health Insurance Program enrollment has declined since 2017, according to new data from the Centers for Medicare and Medicaid Services. But experts and the Trump administration are split on why that is.
The Georgetown University Health Policy Institute Center for Children and Families analyzed enrollment data released Thursday by the government and found that more than 860,000 children dropped from the rolls in 2018.
In a series of tweets on the data, CMS Administrator Seema Verma noted overall enrollment in these two insurance programs has declined by 3.7% since 2017.
However, the policy analysts at Georgetown and Verma paint a different picture on what’s driving this trend. Verma said that an improving economy is helping people in these assistance programs, including children, find other types of coverage.
“It’s always been clear that as the economy improves, unemployment drops and incomes grow, people move off of public assistance programs like Medicaid,” Verma tweeted.
The Georgetown team agrees that likely some children dropping out of Medicaid and CHIP are now covered under a parent’s employer plan. Some may also be covered under individual market plans, they said in their analysis.
However, parents of children under 18 make up just 18% of the workforce, so it’s likely many children are falling through the cracks and becoming uninsured, the analysts said.
There are several factors driving this beyond increases in employment, they said, such as some states—notably Texas—adding red tape to CHIP enrollment, and others grappling with changing eligibility criteria, according to the report.
“While we can’t quantify exactly how many eligible children are becoming uninsured, history tells us that no doubt there are many,” they wrote.
CMS’ full data for 2018 tracks with estimates that about 600,000 children dropped out of public health programs through the first 11 months of 2018.
Verma said on Twitter that CMS is continuing to analyze these enrollment patterns in Medicaid and CHIP and is aiming to dive more fully into factors driving these trends both at the state and national levels.
She also noted that Medicaid and CHIP enrollment, despite these declines, remains notably higher than enrollment before the Affordable Care Act. Enrollment was about 26% higher in 2018 than before the ACA’s full 2014 rollout.
In total, about 72.4 million people were enrolled in Medicaid and CHIP last year, according to CMS, with about 35 million—just over half—being children in either program.