President Barack Obama signing the Affordable Care Act, March 23, 2010. (AP Photo)

(CNSNews.com) - The number of people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) in California alone exceeds the total populations of 44 of the other states of the union, according to data published by the Centers for Medicare and Medicaid Services (CMS) and the Census Bureau.

As of Jan. 1, 2014, states joining Obamacare’s Medicaid expansion could enroll people in the federal-state program under new, relaxed eligibility requirements. California was one of those states.

In the fall of 2013, the Obamacare exchanges opened to enroll people in health insurance plans for 2014.

The average number of Medicaid/CHIP enrollees in California in July-September 2013—the last quarter before the Obamacare exchanges opened--was 7,755,381, according to CMS.

By November 2016, the latest month for which CMS numbers are available, the number of Medicaid/CHIP enrollees in California was 12,209,605.

That is a three-year increase of 4,454,224—or 57.43 percent.

No state has nearly as many Medicaid/CHIP enrollees as California, and no state has added nearly as many to its rolls since the Obamacare exchanges opened, according to CMS.

The 12,209,605 people on Medicaid and CHIP in California as of November 2016 equaled 31.1 percent of the state’s total 2016 population of 39,250,017, as estimated by the Census Bureau.

New York, according to CMS, has the second largest number of people enrolled in Medicaid/CHIP—with 6,411,789.

That is up 733,363—or 12.9 percent—from the average of 5,678,417 people enrolled in Medicaid/CHIP in New York in July-September 2013.

In addition to California itself, the five other states that had total populations in 2016 that outnumbered California’s 12,209,605 Medicaid/CHIP enrollees were: Texas (27,862,596); Florida (20,612,439), New York (19,745,289), Pennsylvania (12,802,503) and Illinois (12,801,539).

All other states had total populations that were smaller than the number of people on Medicaid or CHIP in California.

Ohio, the nation’s seventh most populous state, had 11,614,373 people in 2016, according to the Census Bureau. That fell 595,232 short of the 12,209,605 people on Medicaid or CHIP in California.

California’s 4,454,224 increase in the number of people enrolled in Medicaid/CHIP since July-September 2013 is more than the population of half the states.

It is 17,250 more than the 4,436,974 people who lived in Kentucky, the nation’s 26th most populous state.

Nationwide, 74,407,191 people were enrolled in Medicaid or CHIP as of November, according to CMS. The 12,209,605 enrolled in California equaled 16.4 percent of the total national Medicaid/CHIP enrollment.

Meanwhile, California’s total 2016 population of 39,250,017 was 12.15 percent of the nation’s total population of 323,127,513.

“Medicaid is a mean-tested entitlement program that finances the delivery of primary and acute care services, as well as long-term services and supports,” says the Congressional Research Service. “It is a federal-state program, and participation in Medicaid is voluntary for states, though all states and the District of Columbia choose to participate. In order to participate in Medicaid, the federal government requires states to cover certain mandatory populations and benefits, but the federal government also allows states to cover optional populations and services. Due to its flexibility, there is substantial variation among the states in terms of the factors such as Medicaid eligibility, covered benefits, and provider payment rates.”

“The Children’s Health Insurance Program (CHIP),” says CMS, “was established in 1997 to provide new coverage opportunities for children in families with incomes too high to qualify for Medicaid, but who cannot afford private coverage.”

The business and economic reporting of CNSNews.com is funded in part with a gift made in memory of Dr. Keith C. Wold.