Pie Charts Galore! Medicaid, CHIP, ACA & Medicare enrollment by Congressional District

NOTE: This is a work in progress. Check back soon as I'm adding more states every day.

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

As noted in the methodology for each, there's a small amount of fuzziness in some of the numbers for a couple of reasons, the main one being that the "as of" date varies depending on the type of coverage--Medicaid/CHIP total numbers are as of last October, while ACA Expansion Medicaid is as of last June; Medicare data is as of September 2024; and ACA exchange QHPs/BHPs are as of January 2025.

With that in mind, and with the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which passed yesterday, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

The CD-level charts aren't nearly as granular as my national "Psychedelic Donut" version since the more granular data isn't available for many subcategories (besides, there's 436 of them to contend with). In addition, making them to complicated defeats the main purpose of these graphs, which is to be shared as widely as possible to warn people how many of them are at risk.

I've included links to my data sources below (some of these go to my prior blog articles which in turn include direct links to the original data sources & methodology).

Note that it will take some time for me to generate & upload all 436 of these, so please check back soon for updates.

• Total Population from July 2023 estimates via the U.S. Census Dept.
• Percent of total population over 65 from the 2023 American Community Survey (via Census Reporter)
• Uninsured population under 65 from the 2023 American Community Survey (via the Congressional District Dashboard)
• Uninsured population out of total population from the 2023 American Community Survey (via the U.S. Census)
• ACA Qualified Health Plan & Basic Health Plan data via the Centers for Medicare & Medicaid Services (CMS)
• Traditional & ACA Expansion Medicaid data via the Centers for Medicare & Medicaid Services (CMS) & various state HHS Depts.
• Children's Health Insurance Program (CHIP) data via the Centers for Medicare & Medicaid Services (CMS)
• Medicare Fee for Service, Advantage & Dual Eligible Data via 2023 House Ways & Means Report to Congress

UPDATE 3/02/25: I just discovered that the Center on Budget & Policy Priorities (CBPP) has run a new CD-level analysis of total Medicaid/CHIP enrollment using the most recent report from CMS prior to Musk/Trump taking over (as of October 2024). I've used this as the basis for revised CD-level breakouts of Traditional, Expansion and CHIP enrollment within each state using the same statewide proportions of each.

UPDATE 3/05/25: I've also discovered that my assumptions about the breakout of "dual-eligible" Medicaid/Medicare enrollees between FFS & Advantage plans was wrong; KFF provides a handy chart showing the proportions by state as of 2021. All graphs posted to date have been updated to reflect this as well.

UPDATE 3/07/25: So far I've generated charts for every district in Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas & Kentucky. I hope to get through the "M's" by early next week.

UPDATE 3/08/25: Until now, I've dealt with "dual-eligibles" (people enrolled in both Medicare & Medicaid simultaneously) by simply subtracting them from the Medicare totals so as not to double-count them. Going forward, however, I've decided to go the extra mile to display dual-enrollees as well, starting with Maryland. Note that this doesn't change the combined total of Medicare/Medicaid enrollees at all...it just better represents the breakout visually.

I'm going to finish the remaining states first and will then go back and modify the earlier states accordingly.