Health Insurance Marketplace: December Enrollment Report. Appendix A. Total Marketplace Applications, Eligibility Determinations, and Marketplace Plan Selections by Marketplace Type and State, 10-1-2013 to 11-30-2013.

12/11/2013

State Name
Total Number of
Completed
Applications
(2)
Total Individuals Applying for Coverage in Completed Applications
(3)
Number of Individuals Determined Eligible to Enroll in a Marketplace Plan
Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace
(6)
Pending/ Other
(7)
Number of Individuals Who Have Selected a Marketplace Plan
(8)
Total Eligible to Enroll in a Marketplace Plan
(4)
Eligible to Enroll in a Marketplace Plan with Financial Assistance
(5)
Number Number Number Number Number Number Number
States Implementing Their Own Marketplaces (SBMs)
California (9) 250,838 448,133 225,897 158,435 181,817 40,419 107,087
Colorado (10) 35,214 69,961 60,508 N/A N/A 9,453 9,980
Connecticut 25,371 38,046 24,838 16,230 12,635 573 11,631
District Of Columbia (11) 4,709 N/A N/A N/A N/A N/A N/A
Hawaii (12) 3,661 4,974 2,987 117 N/A 1,987 444
Kentucky 87,640 151,255 75,008 27,003 53,046 23,201 13,145
Maryland 22,878 20,761 7,465 5,861 13,296 0 3,758
Massachusetts (13) 27,184 N/A N/A N/A N/A N/A 1,138
Minnesota (14) 32,209 68,927 46,153 15,493 20,108 2,666 4,478
Nevada 14,266 68,984 26,131 16,019 28,588 14,265 4,834
New York (15) N/A 297,331 297,331 80,834 52,888 19,901 45,513
Oregon (16) 20,617 14,116 6,890 5,051 6,461 765 44
Rhode Island 13,082 19,085 6,145 4,130 6,627 6,313 2,669
Vermont 10,240 18,815 15,472 4,348 4,577 N/A 4,987
Washington (17) 127,456 246,967 59,839 30,452 154,060 33,068 17,770
SBM Subtotal 675,365 1,467,355 781,875 363,973 534,103 152,611 227,478
States With Marketplaces that are Supported by or Fully-Run by HHS (FFM)
Idaho (18) 9,505 21,346 15,048 7,133 1,854 4,444 1,730
New Mexico (18) 8,539 16,289 9,058 3,950 4,457 2,774 934
Alabama 25,282 48,916 34,015 12,274 3,074 11,827 3,448
Alaska 2,737 4,919 3,580 1,548 504 835 398
Arizona 36,212 69,810 42,291 16,607 16,680 10,839 3,601
Arkansas 17,983 34,591 13,568 6,070 11,260 9,763 1,404
Delaware 4,185 7,650 4,484 1,669 1,822 1,344 431
Florida 150,142 281,517 209,540 75,480 18,822 53,155 17,908
Georgia 61,443 122,543 87,367 29,366 10,925 24,251 6,859
Illinois 67,036 124,252 73,949 28,689 30,446 19,857 7,043
Indiana 34,702 69,701 38,745 18,021 16,723 14,233 3,492
Iowa 12,755 25,007 12,613 4,946 7,382 5,012 757
Kansas 12,900 26,617 19,038 7,210 2,353 5,226 1,855
Louisiana 17,662 32,300 23,208 8,214 1,751 7,341 2,193
Maine 8,837 16,325 12,667 5,945 1,079 2,579 1,747
Michigan 52,780 98,235 74,693 29,222 7,363 16,179 6,847
Mississippi 9,992 18,809 13,050 3,974 1,214 4,545 802
Missouri 31,474 62,964 43,661 16,911 6,487 12,816 4,124
Montana 6,737 13,244 9,637 4,778 637 2,970 1,382
Nebraska 11,225 22,895 16,542 7,602 2,679 3,674 1,965
New Hampshire 8,763 17,234 12,768 4,927 1,204 3,262 1,569
New Jersey 51,019 95,800 50,458 19,582 25,286 20,056 3,259
North Carolina 63,568 124,352 89,335 35,589 9,948 25,069 8,970
North Dakota 2,253 4,350 2,637 1,145 1,001 712 265
Ohio 51,511 96,409 72,784 27,439 9,231 14,394 5,672
Oklahoma 14,875 30,786 21,261 5,524 2,747 6,778 1,673
Pennsylvania 74,185 136,606 100,535 39,923 6,792 29,279 11,788
South Carolina 24,768 46,494 33,596 12,242 4,099 8,799 2,761
South Dakota 3,114 6,505 4,636 1,863 540 1,329 372
Tennessee 39,231 73,746 52,987 19,552 5,768 14,991 4,507
Texas 118,577 244,695 177,472 62,321 16,767 50,456 14,038
Utah 13,663 33,015 20,078 9,534 8,062 4,875 1,865
Virginia 45,806 90,050 67,967 22,110 6,202 15,881 4,946
West Virginia 8,570 15,797 7,179 3,140 4,690 3,928 775
Wisconsin 47,173 85,863 50,733 24,140 18,768 16,362 5,303
Wyoming 2,871 5,612 4,228 1,918 357 1,027 521
FFM Subtotal 1,152,075 2,225,244 1,525,408 580,558 268,974 430,862 137,204
MARKETPLACE TOTAL, All States 1,827,440 3,692,599 2,307,283 944,531 803,077 583,473 364,682

Notes:

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

(1) Unless otherwise noted, the data in this table represent cumulative Marketplace enrollment-related activity for 10/1/13 to 11/30/13. For additional methodological information, please refer to Appendix B of this report.
(2) “Completed Applications” represents the total number of electronic and paper applications that were submitted to the Marketplace during the reference period with sufficient information to begin performing eligibility determinations for enrollment in a plan through the Marketplace and, if appropriate, sufficient information to begin performing eligibility determinations for advance payments of the premium tax credit and cost-sharing reductions, and eligibility assessments or determinations for Medicaid and CHIP.
(3) “Individuals Applying for Coverage in Completed Applications” represents the total number of individuals included in Completed Applications that were submitted to the Marketplace during the applicable reference period. This number does not include individuals applying through the SHOP. Note: SBM data on the number of Individuals Determined Eligible to Enroll in a plan through the Marketplace and the number of Individuals Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace do not add to the total number of persons applying for coverage in completed applications due to missing data and differences in process flows for Marketplace Plans and Medicaid/CHIP eligibility determinations / assessments.
(4) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace” (i.e., a Marketplace plan) represents the total number of individuals for whom a Completed Application has been received and who are determined to be eligible for plan enrollment through the Marketplace 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.
(5) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace with Financial Assistance” represents the total number of individuals determined eligible to enroll in a Marketplace plan who qualify for an advance premium tax credit (APTC), with or without a cost-sharing reduction (CSR).
(6) “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 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 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. These data may vary slightly from accounts transferred via ‘flat file’ to states by the FFM. The Nov 13 report included data on some applications received in October that had not completed all steps required for a determination or assessment; these numbers have been updated here. Additional quality assurance is taking place on Medicaid assessments and determinations in advance of transfers to states and these figures might alter further based on that review. Note: this data element does not include eligibility determinations made by State Medicaid/CHIP agencies based on applications originally submitted to the State agency or other Medicaid/CHIP assessments or determinations.
(7) “Pending / Other”: A derived estimate for individuals who have a completed and processed application, who either: 1) have a pending eligibility determination or assessment for Marketplace plan or Medicaid/CHIP coverage; 2) have a completed eligibility determination or assessment for Marketplace plan or Medicaid/CHIP coverage that is not captured in the relevant column in this table for a given state due to system issues; or 3) have been deemed ineligible for Marketplace plan coverage. The Pending/Other totals shown in this table represent the sums of the corresponding state-level Pending/Other counts.
(8) “Individuals Who Have Selected a Marketplace plan” represents the total number of “Individuals Determined Eligible to Enroll in a plan Through the Marketplace” who have selected a plan (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.
(9) California -- California's cumulative data for "Determined or Assessed Eligible for Medicaid/CHIP by the Marketplace" and “Number of Individuals Who Have Selected a Marketplace Plan” for 10/1/13 through 11/30/13 includes two days of duplicate activity (11/1/13 and 11/2/13) that have not yet been verified by the state and removed from the total.
(10) Colorado -- Colorado’s data for “Eligible to Enroll in a Marketplace Plan with Financial Assistance” is marked as “N/A” because the state is verifying its numbers. Additionally, because the Colorado Marketplace does not have an integrated eligibility system, data for “Individuals Assessed Eligible for Medicaid/CHIP” are not available.
(11) District of Columbia -- Data are currently not available for the District of Columbia on the number of individuals applying for coverage, deemed eligible for or enrolled in Marketplace plan, or or enrolled in Medicaid/CHIP; the District of Columbia’s information systems record data by accounts rather than number of individuals or covered lives. In many instances, the accounts reflect two or more individuals.
  (12) Hawaii -- Because the Hawaii Marketplace’s eligibility system is not integrated with its state Medicaid department, the data for “Individuals Assessed Eligible for Medicaid/CHIP” are not available at this time. In addition, the Marketplace is in the process of receiving data from the state Medicaid department on applicants who have been determined ineligible for Medicaid or CHIP. It is anticipated that the proportion of QHP eligible individuals with Financial Assistance will increase as these applicants are transferred from the Medicaid agency to the Marketplace. (13) Massachusetts – Massachusetts’s “Total Number of Completed Applications” does not include completed paper applications. Additionally, due to Massachusetts’s system constraints, cumulative values for several measures are not available at this time.
(14) Minnesota -- Minnesota's cumulative data for “Individuals Determined Eligible to Enroll in a Marketplace Plan,” “Individuals Determined Eligible to Enroll in a Marketplace Plan with Financial Assistance,” and “Individuals Who Have Selected a Marketplace Plan” do not include adults between 133% and 200% of the Federal Poverty Level (FPL) because these individuals are enrolled in the MinnesotaCare program. In addition, children up to 275% FPL are covered through the Medicaid program. Hence, when comparing Minnesota's cumulative data for these indicators with other State-Based Marketplaces, the number of individuals determined eligible for MinnesotaCare and enrolled in MinnesotaCare are worth noting. For example, MNCare’s enrollment of 5,703 during 10/1 – 11/30 might be added to the 4478 Individuals Who Have Selected a Market Plan, for a comparable total of 10,181
(15) New York -- • New York -- New York’s cumulative totals for “Number of Persons Applying for Coverage in Completed Applications” are estimates.
(16) Oregon -- Between 10/01 and 11/02, Oregon had not yet started using its electronic eligibility determination system. In that period, Cover Oregon began receiving and processing paper applications (including applications by postal mail, fax, and fillable PDF). The “Completed Applications” indicator for this period reflects complete paper applications received. Midway through the time period 11/03 – 11/30, Oregon began using its electronic determination system to process paper applications. The “Completed Applications” indicator in this period reflects all applications that were ready to process for determination in the period.
(17) Washington -- Washington’s cumulative for “Individuals Assessed Eligible for Medicaid/CHIP” may include some persons whose eligibility is being re-determined rather than newly determined. For example, an application for a family may include parents applying to the Marketplace for initial coverage, while children are already covered.
(18) Idaho and New Mexico are Federally supported SBMs for 2014; they are using the FFM platform for 2014.
Source: Centers for Medicare & Medicaid Services, as of 12-10-2013.

 

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