The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including PCCM, MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing. "--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.

Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2023. That is a significant increase from around ** million ten years earlier. Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare. From the beginning to ObamacareMedicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2022. Who is enrolled in Medicaid?Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for **** percent of total enrollment, were responsible for **** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.

This dataset represents the number of Medicaid eligible individuals receiving the various Medicaid services over time.

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Total Medicaid Enrollees represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and Medicare-Medicaid ("dual") enrollees. Total Medicaid enrollment in Any Type of Managed Care represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, and PCCMs. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), or PACE program. It excludes beneficiaries who are enrolled in a Financial Alignment Demonstration Medicare-Medicaid Plan as their only form of managed care. The “Medicaid Enrollment in Comprehensive MCOs Under ACA Section VIII Expansion” column is a subset of the total reported in column C and includes individuals who are enrolled in comprehensive MCOs and are low-income adults, with or without dependent children, eligible for Medicaid under ACA Section VIII. n/a" indicates that a state or territory was either not able to report data or does not operate a managed care program.

All states (including the District of Columbia) are required to provide data to The Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) indicators related to key application, eligibility, enrollment and call center processes. These data reflect enrollment activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, as well as state program performance. States submit this data via the Performance Indicator dataset. Further information about this dataset is available at: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance/index.html.

In order to facilitate public review and access, enrollment data published on the Open Data Portal is provided as promptly as possible after the end of each month or year, as applicable to the data set. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly.

As a general practice, for monthly data sets published on the Open Data Portal, DSS will continue to refresh the monthly enrollment data for three months, after which time it will remain static. For example, when March data is published the data in January and February will be refreshed. When April data is published, February and March data will be refreshed, but January will not change. This allows the Department to account for the most common enrollment variations in published data while also ensuring that data remains as stable as possible over time. In the event of a significant change in enrollment data, the Department may republish reports and will notate such republication dates and reasons accordingly. In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. Effective January 1, 2021, this coverage group have been separated: (1) the COVID-19 Testing Coverage for the Uninsured is now G06-I and is now listed as a limited benefit plan that rolls up into “Program Name” of Medicaid and “Medical Benefit Plan” of HUSKY Limited Benefit; (2) the emergency medical coverage has been separated into G06-II as a limited benefit plan that rolls up into “Program Name” of Emergency Medical and “Medical Benefit Plan” of Other Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. This data represents number of active recipients who received benefits under a program in that calendar year and month. A recipient may have received benefits from multiple programs in the same month; if so that recipient will be included in multiple categories in this dataset (counted more than once.) 2021 is a partial year. For privacy considerations, a count of zero is used for counts less than five. NOTE: On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, corrections in the ImpaCT system for January and February 2019 caused the addition of around 2000 and 3000 recipients respectively, and the counts for many types of assistance (e.g. SNAP) were adjusted upward for those 2 months. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. 2. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree. NOTE: On February 14 2019, the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged. NOTE: On 11/30/2018 the counts were revised because of a change in the way active recipients were counted in one source system.

The table Main data is part of the dataset Medicaid Enrollment Data Collected Through MBES, available at https://redivis.com/datasets/1189-2sp8hxm6y. It contains 5289 rows across 10 variables.

This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

The CMS Program Statistics - Medicare-Medicaid Enrollment tables provide data on characteristics of the Medicare-Medicaid enrollee population. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR ENROLL AB 40. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility, Yearly Trend MDCR ENROLL AB 41. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and by Demographic Characteristics MDCR ENROLL AB 42. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and Area of Residence MDCR ENROLL AB 43. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility, Yearly Trend MDCR ENROLL AB 44. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility and by Demographic Characteristics MDCR ENROLL AB 45. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility and Area of Residence MDCR ENROLL AB 46. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility, Yearly Trend MDCR ENROLL AB 47. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility and by Demographic Characteristics MDCR ENROLL AB 48. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility and Area of Residence

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each managed care plan type over the year (duplicated count); (2) the number of beneficiaries enrolled in each managed care plan type as of an individual’s last month of enrollment (duplicated count); and (3) average monthly enrollment in each managed care plan type. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some cells have a value of “DS”. Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data.

1. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program.

2. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals receiving full Medicaid benefits or Medicaid cost sharing.

3. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities.

4. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.

This dataset aggregates and displays the number of New York State Medicaid enrollees by eligibility year and month within each NYS Economic Region; health insurance plan information; and enrollee demographics. For more information, check out http://www.health.ny.gov/health_care/medicaid/, or go to the "About" tab.

Medicaid enrollment by state for all 50 states and DC.

This report is composed annually and profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. This report also provides national-level summary tables relating to trends, breakout of managed care entities, managed care enrollment by state, regional breakout and states with comprehensive health care reform demonstrations.

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

Medicaid is an important public health insurance for individuals with a low income, those that are pregnant, disabled or are children. It was projected that by 2020 there would be approximately **** million Medicaid enrollees. By 2027 that number is expected to increase to ** million individuals covered.

Medicaid in the focus

Medicaid has recently been in the news for several reasons. A proposed Medicaid expansion was announced with the implementation of the Affordable Care Act in 2010. According to the expansion, all states were given the option to expand Medicaid programs to help provide insurance coverage to millions of U.S. Americans. As of 2019, ** states have accepted federal funding to expand their Medicaid programs. Medicaid, after Medicare and private insurance, provides a significant proportion of the total health expenditures in the United States. In general, Medicaid expenditure, like the number of enrollees, has been growing over time.

Medicaid demographics

A significant proportion of Medicaid enrollees in the U.S. are children and low-income adults. Despite children accounting for most of the enrollees in the Medicaid program, the largest percentage of expenditures for Medicaid is dedicated to those enrolled as a disabled individual. Expenditures for the program also vary regionally. The states with the highest Medicaid expenditures include California, New York and Texas, to name a few.

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts.

1. The information in this table was provided by state officials. In some cases, program or plan names in this table differ from those used in publicly available sources. Questions regarding state-specific information in this table should be directed to State/territorial Medicaid officials.

Total Medicaid Enrollees - VIII Group Break Out Report Reported on the CMS-64

The enrollment information is a state-reported count of unduplicated individuals enrolled in the state’s Medicaid program at any time during each month in the quarterly reporting period. The enrollment data identifies the total number of Medicaid enrollees and, for states that have expanded Medicaid, provides specific counts for the number of individuals enrolled in the new adult eligibility group, also referred to as the “VIII Group”. The VIII Group is only applicable for states that have expanded their Medicaid programs by adopting the VIII Group. This data includes state-by-state data for this population as well as a count of individuals whom the state has determined are newly eligible for Medicaid. All 50 states, the District of Columbia and the US territories are represented in these data.

Notes: 1. “VIII GROUP” is also known as the “New Adult Group.” 2. The VIII Group is only applicable for states that have expanded their Medicaid programs by adopting the VIII Group. VIII Group enrollment information for the states that have not expanded their Medicaid program is noted as “N/A.”

In the state of California, there were approximately *** million children enrolled in Medicaid and CHIP insurance plans in March 2025. Additionally, Texas, New York, and Florida all had more than *** million children enrolled in the programs. How many people are enrolled in Medicaid/CHIP? State Medicaid programs provide medical coverage to millions of Americans, including children, pregnant women, and parents. The Children’s Health Insurance Program (CHIP) was introduced in 1997 to help uninsured children who were previously not eligible for Medicaid. The total number of individuals enrolled in Medicaid and CHIP was approximately **** million in May 2021, and California has the largest state program. How is income eligibility determined? The Affordable Care Act established a new methodology to assess income eligibility for Medicaid and CHIP. The adoption of the Modified Adjusted Gross Income (MAGI) methodology helped to align eligibility rules that previously varied nationwide. In general, an individual’s eligibility is now determined by their MAGI and where it falls in relation to the federal poverty level (FPL). For Medicaid and CHIP plans across all states in 2021, the median upper income eligibility level for children was *** percent of the FPL.

NCHS has linked various surveys with Medicaid enrollment and claims records collected from the Centers for Medicare & Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS). Linkage of the NCHS survey participants with the CMS T-MSIS data creates a new data resource that can support research studies focused on a wide range of patient health outcomes and the association of means-tested government insurance programs on health and health outcomes.