CMS says it has identified 2.8 million Americans that have possibly either enrolled in Medicaid or CHIP in multiple states or have simultaneously enrolled in both Medicaid/CHIP and a subsidized ACA plan.
The agency examined 2024 program enrollment data and found that an average of 1.2 million Americans each month were enrolled in Medicaid/CHIP in two or more states, and an average of 1.6 million Americans each month were enrolled in both Medicaid/CHIP and a subsidized ACA plan.
“We are going to work with states to identify individuals enrolled in multiple programs and fix the duplicate enrollment problem to save taxpayers billions of dollars, while minimizing inappropriate coverage loss,” CMS Administrator Mehmet Oz, MD, said July 17. “This is exactly why we fought for stronger tools in the One Big Beautiful Bill Act—to go after this type of waste and finally put a stop to paying twice for the same person’s health coverage.”
To reduce duplicate enrollment moving forward and potentially save $14 billion annually, CMS will give states a list of people who are enrolled in Medicaid or CHIP in more than one state, asking them to double-check eligibility so they don’t lose coverage by mistake. For people who are enrolled in both Medicaid or CHIP and an ACA plan, CMS has notified them and asked them to either drop coverage if no longer eligible, stop the subsidy, or let the exchange know if there’s an error and provide proof. After 30 days, subsidies will end for anyone still showing as enrolled in both.
Medicaid managed care insurers received at least $4.3 billion in duplicate payments for beneficiaries enrolled in multiple states between 2019 and 2021, The Wall Street Journal reported in March. In many cases, Medicaid beneficiaries move to another state, but do not disenroll from Medicaid coverage in their former state.
