The Continuity of Medicaid Coverage: An Update

Medicaid provides critical health insurance coverage to tens of millions of children, adults, elderly and people with disabilities every year. Under the Affordable Care Act (ACA), millions more will gain Medicaid coverage, beginning in 2014. However, Medicaid can be like a leaky sieve: every year millions of people enroll, only to subsequently lose their coverage, even though they are still eligible, due to cumbersome paperwork requirements and small, often short-term, increases in income. The problem of beneficiaries entering and exiting Medicaid is sometimes called “churning.” This report examines the impact of churning in every state. The authors found that the national average continuity of Medicaid coverage improved modestly, from an average of 78.5 percent in 2006 to 81.2 percent in 2010-11, although there are still large differences across the states.