The increase is significant because it shows Medicaid enrollment continued to grow even after the new state and federal online insurance exchanges closed their open enrollment period for private insurance at the end of March. Advocates say the increase also shows states are making headway reducing the backlog of Medicaid applications that built up because of communications problems between  and states and other state technological issues.

Overall, Medicaid enrollment in 47 states and the District of Columbia topped 65 million in April, compared to 59 million in September for those same states, from the Centers for Medicare & Medicaid Services. Connecticut, Maine and North Dakota did not report their Medicaid enrollments.

States that expanded eligibility under the Affordable Care Act to cover residents with incomes up to 138 percent of federal poverty level (about $16,100 for an individual) saw Medicaid enrollments grow by an average of 15.3 percent. States that did not expand reported a 3.3 percent increase.

“This is good news,” said Rachel Klein, director of organizational strategy & enrollment at Families USA, a consumer advocacy group. “This increase reflects the ongoing outreach effort in states … and that states are still processing applications they received earlier.”

Twenty-six states have expanded Medicaid, although New Hampshire is not scheduled to implement it until July. Michigan’s expansion began April 1 — and it has added more than 270,000 people to the program since then, according to .

Medicaid rolls in West Virginia, Oregon and Nevada, all of which expanded eligibility, increased at the fastest pace — all had more than 40 percent growth since September, the CMS report said

Even some states that did not expand saw a surge of enrollees as thousands of people who were previously eligible but not enrolled signed up.  Enrollment in  by more than 14 percent as the state made concerted effort to find those who were previously eligible. Florida, Georgia and Kansas — whose Republican leaders have been hostile to the health law — saw Medicaid grow by about 7 percent since September.

Medicaid enrollment dropped in four states since September — Alabama, Missouri, Nebraska and Wyoming. None expanded eligibility.

While the open enrollment period has ended for buying private insurance through the federal or state marketplaces, consumers may apply for Medicaid and CHIP coverage year round.

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