Medicaid policy data for evaluating eligibility and programmatic changes

Medicaid and the Children's Health Insurance Program (CHIP) provide health insurance coverage to approximately 85 million Americans as of late 2023. There is substantial variation in eligibility criteria, application procedures, premiums, and other programmatic characteristics across states and over time. Analyzing changes in Medicaid policies is important for state and federal agencies and other stakeholders, but such analysis requires data on historical programmatic characteristics that are often not available in a form ready for quantitative analysis. Our objective is to fill this gap by synthesizing existing qualitative policy data to create a new data resource that facilitates Medicaid policy research. Our source data were the 50-state surveys of Medicaid and CHIP eligibility, enrollment, and cost-sharing policies conducted near annually by KFF since 2000, which we originally coded through 2020. These reports are a rich source of point-in-time information but not operationalized for quantitative analysis. Through a review of the measures captured in the KFF surveys, we developed five Medicaid policy domains with 122 measures in total, with each coded by state-quarter—1) eligibility (28 measures), 2) enrollment and renewal processes (39), 3) premiums (16), 4) cost-sharing (26), and 5) managed care (13). 1 (June 28, 2023) – original version 2 (March 14, 2024) – re-reviewed, corrected (where necessary), and extended five income eligibility measures (inc_inf, inc_child_1_5, inc_child_6_18, inc_parents, and inc_preg) through January 2023