November 2016 Medicaid and CHIP Enrollment Data Highlights

The November 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report represents state Medicaid and Children's Health Insurance Program (CHIP) agency activity for the month. The report is one of a series of reports on state Medicaid and CHIP data, and it includes data reported by states.  As with previous reports, this month’s report contains preliminary data and includes data for all states on the following indicators (the term "states" includes all 50 states and the District of Columbia):

  • The number of applications submitted directly to Medicaid and CHIP agencies, including those received through State-Based Marketplaces (SBMs);
  • The number of eligibility determinations made by Medicaid and CHIP agencies on the applications described above, as well as applications to the Federally-Facilitated Marketplace (FFM) in states for which the FFM makes an eligibility assessment (and the state then completes the Medicaid or CHIP determination); and
  • The total number of individuals enrolled in the Medicaid and CHIP programs who are receiving comprehensive benefits, including details on the total number of children enrolled in these programs.

Read additional background information about the monthly enrollment report. 

Highlights from the November 2016 Report

Medicaid and CHIP Total Enrollment

bar chart state map 74,407,191 individuals were enrolled in Medicaid and CHIP in the 51 states reporting November 2016 data.  68,885,189 individuals were enrolled in Medicaid and 5,522,002 individuals were enrolled in CHIP (please see contextual information below regarding CHIP enrollment). Over 16.4 million additional individuals were enrolled in Medicaid and CHIP in November 2016 as compared to the period prior to the start of the first Marketplace open enrollment period (July - Sept. 2013), in the 49 states that reported relevant data for both periods, representing nearly a 29 percent increase over the baseline period. (Connecticut and Maine aren't included because they did not report data for both periods). View graph of Medicaid and CHIP Enrollment Growth over Baseline.

Medicaid Child and CHIP Total Enrollment

people and bar chartNearly 35.8 million individuals are enrolled in CHIP or are children enrolled in the Medicaid program in the 48 states that reported child enrollment data for November 2016. Children enrolled in the Medicaid program and individuals enrolled in CHIP make up over 50.5 percent of total Medicaid and CHIP program enrollment. View graph of Medicaid Child and CHIP Enrollment.

Important Contextual Information

  • Not all states are included in each of these figures due to missing data. Also, some states included in these figures report data that deviate from CMS's specifications. For a listing of state-specific data quality limitations, please see the full report.
  • Other sources of enrollment data, including data from the Statistical Enrollment Data System (SEDS) and Medicaid Budget and Expenditure System (MBES), may not align with the enrollment data included in this report because of methodological differences. For example, in the most recent published SEDS annual enrollment report, CHIP enrollment was reported as approximately 8.4 million. Unlike the point-in-time, monthly enrollment counts included in this report, the SEDS CHIP enrollment figure represents the number of individuals ever enrolled in CHIP throughout the year. SEDS total and state-specific annual enrollment data.
  • 49 states reported both November 2016 enrollment data and data from July-September 2013. These 49 states reported total enrollment in November 2016 of nearly 73.4 million individuals, and July-September 2013 average enrollment of approximately 57 million. For November 2016, CMS is reporting growth of 16,405,344 compared to July-September 2013. This figure is less than the 16,954,576 in net enrollment growth that was included in the Medicaid and CHIP: October 2016 Applications, Eligibility Determinations, and Enrollment Report by nearly 550,000.  This difference does not match the 36,099 increase in the full report for the October to November 2016 period because Florida updated its baseline data this month and Montana and North Dakota updated their enrollment methodologies, which means that the summary statistics in the October 2016 report are not perfectly comparable to the figures in this report. Please note, the July-September 2013 data may contain individuals with retroactive Medicaid coverage, and the November 2016 data included in this report is preliminary. Therefore, the difference reported here between November 2016 and July-September 2013 period is likely understated.
  • Florida revised its enrollment methodology in October 2016 to incorporate its SSI population that were enrolled in Medicaid and to more closely report to CMS’s data specifications, but it was not until November 2016 that Florida was able to fully revise its baseline figure and ensure comparability across all months.  
  • Montana and North Dakota updated their enrollment methodologies in November 2016 to better align with CMS’s data specifications. The states subsequently updated all prior months to ensure comparability across months.
  • The full report contains additional state specific notes