As of 2021, over 82 million Americans were enrolled in their state’s Medicaid and CHIP programs. This number is up by 11.85% from 2020, when close to 74 million were enrolled in Medicaid or CHIP.

Medicaid provides low-cost insurance for individuals who cannot afford individual health insurance or do not receive health coverage through an employer.

Medicaid enrollment changes

Enrollment for Medicaid occurs yearly during the open enrollment period, or after someone experiences a qualifying life event. This is when you can visit the healthcare.gov website to apply and find out whether you are eligible for Medicaid. If you are already enrolled in Medicaid, you must reapply during the open enrollment period.

Nebraska saw the largest jump in Medicaid enrollment with a year-over-year increase of almost 32%. This rise results from Nebraska's expansion of Medicaid effective October 2020, which allowed more residents to qualify for the program based on income.

Medicaid provides coverage for people with low incomes, disabilities or substance abuse disorders. The program offers long-term care benefits — which are not included in private health insurance plans or Medicare — for seniors and those with disabilities. Care is provided in facilities or through home or community-based programs that allow patients to live independently.

The federally funded program also provided opioid addiction help to 4 in 10 nonelderly adults. This allowed individuals to get increased access to treatment centers and intervention courses.

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) is an insurance program that provides low-cost health care to children in families whose household income is too high for Medicaid but not high enough to buy private health insurance. In some states, CHIP also covers low-income pregnant people. Depending on the state, income requirements range from 133% to 185% of the federal poverty level (FPL).

Nationally, CHIP enrollment increased by a little over 2% between 2020 and 2021. The largest change in enrollment can be seen in New Hampshire, which had a year-over-year gain of close to 30% in CHIP enrollment. A rise in CHIP enrollment may be tied to changes in the economy and increased job losses in the state during that period.

Medicaid expansion

Under the Affordable Care Act (ACA), state Medicaid programs can expand their program's eligibility requirements to cover more low-income individuals. The ACA provision expands the income threshold to anyone with an income below 138% of the federal poverty level. As of 2021, 39 states — including Washington, D.C. — have passed legislation that expands Medicaid. Oklahoma and Missouri expanded Medicaid in 2021.

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