The Centers for Medicare & Medicaid Services (CMS) has taken a significant leap forward in enhancing transparency and understanding the demographics of Medicaid and CHIP (Children’s Health Insurance Program) enrollees. For the first time, CMS has provided national estimates of the demographic composition of these crucial healthcare programs. This data, stratified by race, ethnicity, primary language, geography, and disability-based eligibility, sheds light on the diverse makeup of beneficiaries.
A Historic Milestone
The release of this demographic data represents a historic milestone. CMS’s commitment to improving health equity has driven these efforts, resulting in a more comprehensive and accurate depiction of Medicaid and CHIP enrollees. Here are the key insights from this groundbreaking data:
- Diversity in Race and Ethnicity: In 2020, Medicaid and CHIP extended coverage to nearly 55 million individuals from racial and ethnic minority backgrounds. Significantly, program enrollees were found to be more racially and ethnically diverse than the broader U.S. population, particularly among children, where 61 percent of child enrollees came from racial and ethnic minority backgrounds.
- Residence in Rural Areas: Interestingly, Medicaid and CHIP enrollees are slightly more likely to reside in rural areas compared to the overall U.S. population. Rural enrollees are more likely to be non-Hispanic White and non-Hispanic American Indian and Alaska Native (AIAN) than their counterparts in non-rural areas.
- Language Diversity: Language is another dimension of diversity. Over 10 percent of Medicaid and CHIP enrollees speak a primary language other than English. While this figure is slightly lower than the overall U.S. population, it’s a significant segment. Enrollees with a non-English primary language are more likely to be Hispanic or non-Hispanic Asian/Pacific Islander (API). They are also more likely to be over the age of 65 and to have qualified for benefits through an eligibility category open only to older adults.
- Disability-Based Eligibility: In 2020, around 10 million Medicaid enrollees, constituting 11 percent of the Medicaid population, qualified for benefits based on disability. Many of these individuals obtained Medicaid coverage because they receive Supplemental Security Income (SSI), indicating limited financial means and a long-lasting disabling condition. Interestingly, Medicaid enrollees qualifying for benefits based on disability are more likely to be non-Hispanic White or non-Hispanic Black compared to those who qualify through other eligibility categories.
Overcoming Data Challenges
Understanding the significance of these findings requires recognizing the challenges associated with collecting demographic data in Medicaid and CHIP. Historically, data quality issues made it impossible for CMS to analyze the demographic composition of the programs using administrative data. Factors like race, ethnicity, and language, which enrollees are not required to report during eligibility determination, posed challenges. As a result, many enrollees did not report these characteristics, leaving gaps in the understanding of Medicaid and CHIP demographics.
To address these challenges, CMS developed a well-validated, evidenced-based method that combines high-quality, self-reported race and ethnicity data with indirect estimates known as imputation. Geocoding of enrollee address information also played a crucial role in enabling this new data analysis by geography.
The Road Ahead
The release of this demographic data is just the beginning. CMS plans to build upon this foundation, providing further analyses of demographic data in additional data products. These insights will enable CMS to better serve the diverse population of Medicaid and CHIP beneficiaries and continue its mission to improve health equity.
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