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The discontinuity in Medicaid coverage reported here could stem from several sources, not just “churn,” since no good measure exists to isolate “churning” rates. ACAP also supports the development of approaches to accurately measure the rate of “churn” in the program.

Average continuity was calculated by dividing the average number of monthly Medicaid enrollees in a state by its reported unduplicated total number of Medicaid enrollees and multiplying the result by 12.