Managed Medicaid: CMS April State-Level Medicaid Enrollment Snapshot: Continued -MSD% Y/Y Declines

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Managed Medicaid: CMS April State-Level Medicaid Enrollment Snapshot: Continued -MSD% Y/Y Declines

J P M O R G A N North America Equity Research

02 August 2026

Managed Medicaid

CMS April State-Level Medicaid Enrollment Snapshot:

Continued -MSD% Y/Y Declines

On Friday, CMS updated its state-level Medicaid snapshot, which provides an Managed Care and Facilities

ACinteresting view of the Medicaid landscape through April 2026. As we cover John Stansel, CFA

below, Medicaid enrollment continues to attrit, consistent with 1H commentary (1-212) 622-0083

from MCOs, all of which we believe saw core Medicaid enrollment decline in 1Q john.stansel@jpmorgan.com

and 2Q, with CNC notably increasing its expectation for y/y Medicaid enrollment Lisa C. Gill

declines during 2Q. Y/Y declines in the CMS data accelerated slightly in early 2026 (1-212) 622-6466

(down ~4.7% y/y in April, by our estimates) vs. March 2026 (down ~4.4% y/y, by lisa.c.gill@jpmorgan.com

our estimates). Some of the attrition is driven by programmatic and reporting Benjamin Rossi

changes (see the enrollment shifts in California), but the underlying decline (1-212) 622-9603

benjamin.rossi@jpmorgan.com

appears to have accelerated in 2026, with enrollment declining ~0.6% in April

Cole Harris(bringing YTD declines to ~1.8% through April 2026, based on our estimates) and

(1-212) 622-9068

returning to the cadence seen in January/February after a more muted decline in cole.harris@jpmorgan.com

March. More broadly, we see enrollment continuing to decline throughout 2026, J.P. Morgan Securities LLC

with the April run-rate implying a -5% to -6% full-year decline. This remains a

point to watch because, all else equal, we think larger enrollment declines pose a

greater risk of adverse shifts in acuity.