Capitol Correspondence - 12.17.20

MACPAC Releases Updated Data on Medicaid

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To assist our members with their efforts to advocate for and educate policymakers about sensible Medicaid policy, we share this announcement by the Medicaid and CHIP Payment and Access Commission regarding new data on Medicaid general enrollment and spending statistics.

“The Medicaid and CHIP Payment and Access Commission (MACPAC) today released the 2020 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, and beneficiaries’ health, service use, and access to care. From July 2019 to July 2020, enrollment in Medicaid and CHIP increased by about 5.6 percent, driven in large part by the economic downturn created by the COVID-19 pandemic.

Enrollment increased in all states except the District of Columbia and Montana. States where enrollment grew ranged from 0.2 percent in South Carolina to 30.2 percent in Idaho, which adopted the expansion of Medicaid to the new adult group in 2020 (Exhibit 11). […]

Even with the increase in enrollment, Medicaid and CHIP combined still account for a smaller share of total health care spending than Medicare or private insurance. Medicaid accounted for a smaller share of the federal budget (9.2 percent) than Medicare (14.5 percent) in fiscal year (FY) 2019 (Exhibit 4). Medicaid and CHIP together accounted for 16.9 percent of national health expenditures in calendar year 2018, less than either Medicare (20.6 percent) or private insurance (34.1 percent) (Exhibit 3). Medicaid and CHIP expenditures as a share of national health expenditures are projected to grow from 16.8 percent in 2019 to about 16.9 percent in 2028 (Exhibit 12).

‘The COVID-19 pandemic and related unemployment have major implications for Medicaid and CHIP. This publication provides invaluable insights at a critical time for federal and state policymakers, researchers, and anyone who wants to fully understand what’s happening with the health care of the more than one-quarter of the U.S. population who are covered by Medicaid or CHIP,’ said MACPAC Chair Melanie Bella.

More highlights from this year’s edition of MACStats include:

  • Over 40 percent of individuals enrolled in Medicaid or CHIP in 2018 had family incomes below 100 percent of the federal poverty level (Exhibit 2).
  • Medicaid and CHIP enrollees of all ages were more likely to be in fair or poor health than individuals who were covered by private insurance or who were uninsured (Exhibit 2). […]
  • About half of Medicaid spending for enrollees was for capitation payments to managed care plans (Exhibits 17 and 18). Spending for enrollees who are eligible for Medicaid on the basis of disability and enrollees who are age 65 and older has been shifting to managed care. In FY 2018, more than half of enrollees who are eligible on the basis of disability and over one third of enrollees age 65 and older were enrolled in comprehensive managed care, including in plans that provided managed long-term services and supports (Exhibit 30). […]

The 2020 edition includes reprints of eight exhibits from the 2019 data book on topics such as beneficiary characteristics, health service use, and access to care. These exhibits have not been updated from last year’s publication due to a delay in the release of data from the National Health Interview Survey. 

Visit this link for the PDF and spreadsheet versions of the December 2020 MACStats: Medicaid and CHIP Data Book. Visit for MACPAC’s newest issue briefs on State Compliance with Electronic Asset Verification Requirements and State Management of Home- and Community-Based Services Waiver Waiting Lists. Follow us on Twitter @macpacgov.”