Alabama Medicaid’s monthly enrollment topped 1 million for the first time in February 2014, boosted largely by the federally-required transfer of children from the state’s All Kids program and changes in how Medicaid eligibility is determined. The milestone increase also reflects the first enrollment of individuals who applied for coverage through the federal “marketplace” under the Affordable Care Act.

In a review of data from the first five months of 2014, Alabama Medicaid’s monthly enrollment increased from 997,545 in January to 1,000,824 in February. That number increased to 1,014,931 in March, 1,020,802 in April, and 1,024,358 in May.

Much of the initial increase – 93 percent – was due to the addition of 23,653 children in January who were required to transfer to Medicaid from the state’s Children’s Health Insurance Program (CHIP). The Affordable Care Act required that children in families with incomes under 133 percent of the Federal Poverty Level to transfer to Medicaid in January 2014. 

As expected, the increased enrollment was primarily seen in the aid categories impacted by recent federal changes in the way income is calculated. The state is now required to use Modified Adjusted Gross Income (MAGI) in determining eligibility for most non-disabled children and adults. Disabled recipients certified by the Social Security Administration, as well as elderly and disabled individuals certified by Alabama Medicaid Agency, do not use MAGI rules to determine eligibility. The rise in enrollment also includes all Medicaid recipients, including those who receive partial or very limited benefits, such as pregnancy-related or family planning services only.