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Explore key characteristics of Medicaid and CHIP in , including documents and information relevant to how the programs have been implemented by within federal guidelines.

has expanded coverage to low-income adults.

As of December 2019, has enrolled 985,201 individuals in Medicaid and CHIP — a net increase of 57.29% since the first Marketplace Open Enrollment Period and related Medicaid program changes in October 2013. has adopted one or more of the targeted enrollment strategies outlined in guidance CMS issued on May 17, 2013, designed to facilitate enrollment in Medicaid and CHIP.

In federal fiscal year (FFY) 2019, voluntarily reported 15 of 22 frequently reported health care quality measures in the CMS Medicaid/CHIP Child Core Set. These counts do not include the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health Plan Survey 5.0H – Child Version Including Medicaid and Children with Chronic Conditions Supplemental Items (CPC-CH) or the Central Line-associated Bloodstream Infection (CLABSI-CH) measures. voluntarily reported 15 of 24 frequently reported health care quality measures in the CMS Medicaid Adult Core Set. These counts do not include the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health Plan Survey 5.0H, Adult Version (Medicaid) (CPA-AD) measure.

More detailed information and source references are available on each of these topics.

  • Most Medicaid eligibility and all CHIP eligibility is based on modified adjusted gross income (MAGI). Income eligibility levels are tied to the federal poverty level (FPL).

    The following table provides a more detailed view of 's MAGI-based eligibility levels, expressed as a percentage of the FPL, for several key groups: children, pregnant women, parents/caretaker relatives, and, other adults

    Medicaid & CHIP Eligibility1 as of October 1, 2020

    Children Eligibility Level
    Children Medicaid Ages 0-12 Eligibility Level
    Children Medicaid Ages 1-52 Eligibility Level
    Children Medicaid Ages 6-182 Eligibility Level
    Children Separate CHIP3 Eligibility Level
    Pregnant Women Eligibility Level
    Pregnant Women Medicaid Eligibility Level
    Pregnant Women CHIP4 Eligibility Level
    Adults (Medicaid) Eligibility Level
    Adults (Medicaid) Parent/Caretaker5 Eligibility Level
    Adults (Medicaid) Expansion to Adults Eligibility Level

    Source: Medicaid Eligibility.

    Learn more about how states determine Medicaid eligibility for other populations.

    View available state's eligibility verifications plans, MAGI Conversion Plans and Results.

    Medicaid and CHIP agencies now rely primarily on information available through data sources (for example, the Social Security Administration, the Departments of Homeland Security and Labor) rather than paper documentation from families for purposes of verifying eligibility for Medicaid and CHIP.

  • Medicaid & CHIP Enrollment Data

    The table below presents the most recent, point-in-time count of total Medicaid and CHIP enrollment in  for the last day of the indicated month, and is not solely a count of those newly enrolled during the reporting period. For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces, and (b) national counts and change statistics for the same period.

    Medicaid & CHIP Enrollment as of December 2019

    Metric National Totals
    Metric Total Medicaid & CHIP Enrollment (Preliminary) National Totals
    Metric Net Change in Enrollment July-September 2013 National Totals
    Metric % Change in Enrollment July-September 2013 National Totals