State Medicaid and CHIP Eligibility Processing Data
All states (including the District of Columbia) provide data to the Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment metrics.
Freshness
- Last posted
- Period covered
- Update frequency
- Monthly
Dates as CMS lists them in its catalog.
Columns 22
| Column | What it means | Type |
|---|---|---|
State Abbreviationstate_abbreviation | string | |
State Namestate_name | string | |
Reporting Periodreporting_period | Reporting period. States did not submit the Eligibility Processing Data Report until the start of their state-specific unwinding period in 2023. For the March 2023 to June 2023 reporting periods, the “Beneficiaries with a Renewal Initiated” metric is blank for states that had not initiated a renewal cohort for the purposes of unwinding, and other metrics are blank for states that did not have a cohort due for renewal in the given month. | integer |
Original or Updatedoriginal_or_updated | text | |
Beneficiaries with a Renewal Initiatedbeneficiaries_with_a_renewal_initiated | The total number of beneficiaries, including those receiving full or limited benefits, with a renewal that was initiated between the first and last day of the reporting period. States do not report this information in the updated reports. Therefore, this metric is blank for updated report records. This metric is set equal to Eligibility Processing Data Report Metric 4. | integer |
Beneficiaries with a Renewal Initiated - footnotesbeneficiaries_with_a_renewal_initiated__footnotes | text | |
Beneficiaries with a Renewal Duebeneficiaries_with_a_renewal_due | The total number of beneficiaries, including those receiving full or limited benefits, with a renewal due, or scheduled for completion, in the reporting period. This metric is set equal to Eligibility Processing Data Report Metric 5. | integer |
Beneficiaries with a Renewal Due - footnotesbeneficiaries_with_a_renewal_due__footnotes | text | |
Beneficiaries Whose Coverage Was Renewed (Total)beneficiaries_whose_coverage_was_renewed_total | The total number of beneficiaries, including those receiving full or limited benefits, whose renewal was due in the reporting period who were renewed and retained in Medicaid or CHIP at the end of the reporting period. This metric is set equal to Eligibility Processing Data Report Metric 5a. | integer |
Beneficiaries Whose Coverage Was Renewed (Total) - footnotesbeneficiaries_whose_coverage_was_renewed_total__footnotes | text | |
Beneficiaries Whose Coverage Was Renewed on an Ex Parte Basisbeneficiaries_whose_coverage_was_renewed_on_an_ex_parte_basis | The total number of beneficiaries, including those receiving full or limited benefits, whose renewal was due in the reporting period who were renewed and retained in Medicaid or CHIP in the reporting period on an ex parte basis. This metric is set equal to Eligibility Processing Data Report Metric 5a1. | integer |
Beneficiaries Whose Coverage Was Renewed on an Ex Parte Basis - footnotesbeneficiaries_whose_coverage_was_renewed_on_an_ex_parte_bas_6356 | text | |
Beneficiaries Whose Coverage Was Renewed based on a Renewal Formbeneficiaries_whose_coverage_was_renewed_based_on_a_renewal_form | The total number of beneficiaries, including those receiving full or limited benefits, whose renewal was due in the reporting period who were renewed and retained in Medicaid or CHIP in the reporting period using a renewal form. This metric is set equal to Eligibility Processing Data Report Metric 5a2. | integer |
Beneficiaries Whose Coverage Was Renewed based on a Renewal Form - footnotesbeneficiaries_whose_coverage_was_renewed_based_on_a_renewal_a744 | text | |
Beneficiaries Disenrolled at Renewal (Total)beneficiaries_disenrolled_at_renewal_total | int | |
Beneficiaries Disenrolled at Renewal (Total) - footnotesbeneficiaries_disenrolled_at_renewal_total__footnotes | text | |
Beneficiaries Determined Ineligible at Renewalbeneficiaries_determined_ineligible_at_renewal | The total number of beneficiaries, including those receiving full or limited benefits, whose renewal was due in the reporting period and who were determined ineligible for Medicaid or CHIP. This metric is set equal to Eligibility Processing Data Report Metric 5b. | integer |
Beneficiaries Determined Ineligible at Renewal - footnotesbeneficiaries_determined_ineligible_at_renewal__footnotes | text | |
Beneficiaries Disenrolled for Procedural Reasons at Renewalbeneficiaries_disenrolled_for_procedural_reasons_at_renewal | The total number of beneficiaries, including those receiving full or limited benefits, whose renewal was due in the reporting period and whose coverage ended because the state has insufficient information to complete an eligibility determination, also known as procedural reasons. This metric is set equal to Eligibility Processing Data Report Metric 5c. | integer |
Beneficiaries Disenrolled for Procedural Reasons at Renewal - footnotesbeneficiaries_disenrolled_for_procedural_reasons_at_renewal_7828 | text | |
Beneficiaries with a Pending Renewalbeneficiaries_with_a_pending_renewal | The total number of beneficiaries, including those receiving full or limited benefits, whose renewals were due in the reporting period but were not completed by the end of the reporting period. This metric is set equal to Eligibility Processing Data Report Metric 5d. | integer |
Beneficiaries with a Pending Renewal - footnotesbeneficiaries_with_a_pending_renewal__footnotes | text |
No column matches that filter.
At a glance
- Catalog
- data.medicaid.gov
- Publisher
- Centers for Medicare & Medicaid Services (CMS), data.medicaid.gov
- Rows
- 3,876
- Columns
- 22
- State column
state_abbreviation- Topics
- Medicaid and CHIP
- Contact
- Medicaid.gov@cms.hhs.gov
API
Free, no key needed. This request returns the first 10 rows as JSON:
https://data.medicaid.gov/api/1/datastore/query/5abea2e0-3f8e-4b49-a50d-d63d5fd9103c/0?limit=10
To keep only one state, filter on the state_abbreviation column.
CMS's description
All states (including the District of Columbia) provide data to the Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment metrics. These data reflect state-reported information on Medicaid and CHIP eligibility renewals initiated and scheduled for completion during the reporting period. In addition to reporting the outcomes of renewals at the end of each reporting period, states also provide an update on renewals that were reported pending as of the end of a reporting period. For more information on these data, see Sections II and III of the Eligibility Processing Data Report specifications . Notes: Georgia reported data for individuals who continue to be eligible following a change in circumstances and were granted a new 12-month eligibility period during the reporting period, along with data on individuals due for renewal in the month. North Carolina reports renewal outcomes for only initiated renewals scheduled for completion in the report month, and as such, the data do not reflect renewals that should have been completed in the reporting period that the state was unable to initiate by the end of the report month.
The summary at the top is the first sentence of this description. Record id mcd:5abea2e0-3f8e-4b49-a50d-d63d5fd9103c. This record as JSON.