Health Insurance Marketplace 2015 Open Enrollment Period: December Enrollment Report. Appendix Table B3

12/30/2014

Total Marketplace Eligibility Determinations, and Marketplace Plan Selections in

States Using the HealthCare.gov Platform, By State, 2015 (1)

11-15-2014 to 12-15-2014

State Name Number of Individuals Determined Eligible to Enroll through the Marketplace for 2015 Coverage Number of Individuals Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace

(4)
Number of Individuals With 2015

Marketplace Plan Selections

(not including automatic reenrollments)

(5)
Total Eligible to Enroll in a Marketplace Plan

(2)
Eligible to Enroll in a Marketplace Plan with Financial Assistance

(3)
Number Number Number Number
States Using the HealthCare.gov Platform
State-Based Marketplaces (SBMs) Using the HealthCare.gov Platform (6)
Nevada  48,812 42,381 13,066 40,285
New Mexico  22,748 17,479 5,249 17,556
Oregon  91,179 73,149 28,043 73,152
Subtotal - SBMs Using the HealthCare.gov Platform 162,739 133,009 46,358 130,993
Federally-Facilitated Marketplace (FFM) States
Alabama  88,942 68,026 3,434 64,926
Alaska  11,536 9,637 1,069 9,325
Arizona  95,610 75,403 16,809 72,932
Arkansas  26,790 22,194 7,347 19,900
Delaware  11,303 8,970 2,219 8,956
Florida  833,380 721,666 48,812 673,255
Georgia  250,766 200,426 22,298 187,654
Illinois  152,589 121,063 29,565 121,243
Indiana  112,811 93,994 22,201 88,733
Iowa  24,432 20,305 5,780 18,913
Kansas  50,871 38,039 3,912 39,023
Louisiana  74,992 60,664 2,341 56,651
Maine  42,945 36,040 2,194 36,132
Michigan  149,270 129,927 36,015 123,208
Mississippi  40,985 33,002 3,092 28,452
Missouri  133,171 106,847 12,560 102,087
Montana 28,444 23,485 759 22,618
Nebraska 40,095 33,285 3,315 32,213
New Hampshire 28,022 19,939 5,005 23,210
New Jersey 136,612 107,585 21,093 105,306
North Carolina 307,667 261,605 20,079 249,784
North Dakota 10,021 8,713 1,279 8,528
Ohio 113,208 93,341 26,263 88,927
Oklahoma 57,763 44,512 4,741 44,129
Pennsylvania 224,707 177,085 31,328 180,046
South Carolina 96,032 77,154 6,647 75,075
South Dakota 12,170 10,072 1,181 8,817
Tennessee 123,419 90,362 11,943 87,137
Texas 52 ,441 401,973 18,211 379,525
Utah 63,619 55,029 11,025 49,740
Virginia 209,955 159,679 14,377 164,884
West Virginia 15,446 12,597 1,512 12,283
Wisconsin 111,434 97,436 7,590 92,398
Wyoming 11,227 9,458 672 9,020
TOTAL – States Using the HealthCare.gov Platform 4,376,414 3,562,522 453,026 3,416,023

Notes:

“N/A” means that the data for the respective metric are not yet available for a given state.

(1) Unless otherwise noted, the data in this table represent cumulative Marketplace enrollment-related activity for 11-15-14 to 12-15-14. These data also do not include any enrollment-related activity relating to individuals who may have applied for and/or selected a 2014 Marketplace plan during the reporting period, as a result of having been granted a Special Enrollment Period (SEP). This table only reflects data for the individual market Marketplaces. For additional technical notes information, please refer to Appendix C of this report.

(2) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace” (i.e., enrollment through the Marketplaces for a 2015 Marketplace plan) represents the total number of individuals for whom a Completed Application has been received for the 2015 plan year (including any individuals with active 2014 Marketplace enrollments who returned to the Marketplaces and updated their information), and who are determined to be eligible for plan enrollment through the Marketplaces during the reference period, whether or not they qualify for advance payments of the premium tax credit or cost-sharing reductions. These individuals may or may not have enrolled in coverage by the end of the reference period. Individuals who have been determined or assessed eligible for Medicaid or CHIP are not included.

(3) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace with Financial Assistance” (i.e., enrollment through the Marketplace for a 2015 Marketplace plan with Financial Assistance) represents the total number of individuals determined eligible to enroll through the Marketplace in a Marketplace plan who qualify for an advance premium tax credit (APTC), with or without a cost-sharing reduction (CSR) for the 2015 plan year (including any individuals with active 2014 Marketplace enrollments who returned to the Marketplace and updated their information). These individuals may or may not have enrolled in coverage by the end of the reference period.

(4) “Individuals Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace” represents the number of individuals who have been determined or assessed by the Marketplace as eligible for Medicaid or CHIP based on their modified adjusted gross income (MAGI). In some states, completed applications for individuals, whom the Marketplace has assessed as potentially eligible for Medicaid or CHIP, based on MAGI, are transferred to the relevant state agency for a final eligibility determination. In these “assessment states” the data include those accounts where a final decision is pending. In other states, the Marketplace has been delegated the final Medicaid/CHIP eligibility determination responsibility for these individuals. Thus, this data element includes FFM determinations and assessments, regardless of the state Medicaid/CHIP agency’s final eligibility determination, if applicable. These data may vary from accounts transferred via “flat file” to states by the FFM. Quality assurance continues on Medicaid assessments and determinations. Note: Marketplace Medicaid/CHIP eligibility determination and assessment data in this report cannot be added to eligibility determination data in the most recent monthly Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment report (available on Medicaid.gov) which covers data through October 2014. In the Marketplaces, some of the individuals assessed or determined eligible for Medicaid or CHIP by the Marketplace and reported in this report may also be reported in the monthly Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Report when the state has made an eligibility determination based on the information provided by the Marketplace. Total Medicaid/CHIP enrollment is reported in the monthly Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Report, and is a point-in-time count of total enrollment in the Medicaid and CHIP programs at the end of the monthly reporting period.

(5) “Individuals With 2015 Marketplace Plan Selections” represents the total number of individuals determined eligible to enroll in a plan through the marketplace” who have selected a 2015 Marketplace medical plan for enrollment through the Marketplaces or, after December 15, have been automatically reenrolled in Marketplace coverage (with or without the first premium payment having been received directly by the Marketplace or the issuer) during the reference period. This is also known as pre-effectuated enrollment. These data do not include: cancellations and terminations; a count of the number of individuals who have selected a standalone dental plan; or individuals who may have selected a 2014 Marketplace plan during the reporting period, as a result of having been granted a Special Enrollment Period (SEP).

(6) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.

Source: Centers for Medicare & Medicaid Services, as of 12-23-2014.

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