A recent release from the Center on Medicare and Medicaid Services shows that across the U.S. Medicaid enrollment grew by 5.8 million from right before the open enrollment period (July-September 2013) to March 2014, a growth rate of almost 10%.  However, as would be expected most of this growth occurred in states that chose to expand Medicaid coverage.  Nevertheless, even the remaining states have experienced growth of over 640 thousand (or about 2.6%).

However, the report highlights a perplexing finding: the change in Medicaid enrollment in Missouri since September 2013 is -3.9% (or a drop of roughly 33,800 persons), the second largest drop in Medicaid enrollment in the country (second only to Wyoming, which observed a 5.6% drop). Medicaid officials from Missouri have attributed this drop in part to declining unemployment rates in the state
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The attach report by this author shows definitively that the recent drops in Medicaid eligibility determinations in Missouri cannot be explained by a drop in unemployment in MissouriIn fact, while Missouri has experienced a drop of roughly 4% in Medicaid eligibility (about 34,000), unemployment in Missouri rose over the period covered by the report by almost 10,000 jobs while Medicaid eligibility levels dropped, contrary to what officials suggest is the explanation for the declining enrollment trends. In addition, and perhaps most important, Missouri‚Äôs Medicaid enrollment trends buck the trends nationwide. 

The brief lays out several potential alternative explanations for the trends in Medicaid enrollment in Missouri and suggests that the decline in Medicaid determinations is a 
significant policy concern for state officials and policymakers. To rectify the problems, a determination of the actual causes of the problems should be made as soon as possible, and solutions put in place quickly to resolve the problems.