Long-Term Stability of Coverage Among Michigan Medicaid Beneficiaries : A Cohort Study.

<bold>Background: </bold>Medicaid, the primary source of insurance coverage for disadvantaged Americans, was originally designed as a temporary safety-net program. No studies have used long-run data to assess the recent use of the program by beneficiaries.<bold>Objective: </bold>To assess patterns of short- and long-term enrollment among beneficiaries, using a 10-year longitudinal panel of Michigan Medicaid eligibility data.<bold>Design: </bold>Primary analyses assessing trends in Medicaid enrollment among cohorts of existing and new beneficiaries.<bold>Setting: </bold>Administrative records from Michigan Medicaid for the period 2011 to 2020.<bold>Participants: </bold>3.97 million Medicaid beneficiaries.<bold>Measurements: </bold>Short- and long-term enrollment in the program.<bold>Results: </bold>The sample includes 3.97 million unique beneficiaries enrolled at some point between 2011 and 2020. Among a cohort of 1.23 million beneficiaries enrolled in 2011, over half (53%) were also enrolled in Medicaid in June 2020, spending, on average, two-thirds of that period (67%) on Medicaid. These beneficiaries, however, experienced substantial lapses in coverage, as only 25% were continuously enrolled throughout the period. Enrollment was less stable when assessed from the perspective of newly enrolled beneficiaries, of whom only 37% remained enrolled at the end of the study period.<bold>Limitation: </bold>Primary estimates from a single state.<bold>Conclusion: </bold>For many beneficiaries, Medicaid has served as their primary source of coverage for at least a decade. This pattern would justify increasing investments in the program to improve long-term health outcomes.<bold>Primary Funding Source: </bold>Self-funded. [ABSTRACT FROM AUTHOR]