Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using State-based Marketplaces (SBMs) that use their own eligibility and enrollment platforms

Source: State-based Marketplace (SBM) operational data submitted to CMS. Each monthly reporting period occurs during the first through last day of the reported month. For April, Idaho’s reporting period was from February 1, 2023 to April 30, 2023. April data include the following SBMs: Connecticut, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, Pennsylvania, Vermont, and Washington. May data include the previous SBMs and the following new SBMs: Colorado, District of Columbia, New York, and Rhode Island. June data include the previous SBMs and the following new SBM: California. The following data through October include all previous SBMs. Some SBMs did not receive applicable applications during certain reporting period months. Some SBMs may revise data from a prior month and thus these data may not align with data previously reported.

Notes:

1. This table represents consumers whose Medicaid/CHIP coverage was denied or terminated following renewal and 1) whose applications were processed by an SBM through an integrated Medicaid, CHIP, and Marketplace eligibility system or 2) whose applications/information was sent by a state Medicaid or CHIP agency to an SBM through an account transfer process. Consumers who submitted applications to an SBM that can be matched to a Medicaid/CHIP record are also included. See the ""Data Sources and Metrics Definition Overview"" at http://www.medicaid.gov for a full description of the differences between the SBM operating systems and resulting data metrics, measure definitions, and general data limitations. As of the September 2023 report, this table was updated to differentiate between SBMs with an integrated Medicaid, CHIP, and Marketplace eligibility system and those with an account transfer process to better represent the percentage of QHP selections in relation to applicable consumers received and processed by the relevant SBM. State-specific variations are: - Maine’s data and Nevada’s April and May data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process. - Connecticut, Massachusetts, and Washington also report applications with consumers determined ineligible for Medicaid/CHIP due to procedural reasons. - Minnesota and New York report on eligibility and enrollment for their Basic Health Programs. - Idaho’s April data on consumers eligible for a QHP with financial assistance does not depict a direct correlation to consumers with a QHP selection. - Pennsylvania conducts automatic QHP eligibility determinations for Marketplace plans for some account transfers. As of the December 2023 report, Pennsylvania revised its data to report those consumers in the account transfer and application metrics. - Only SBMs with an automatic plan assignment process have and report automatic QHP selections. These SBMs make automatic plan assignments into a QHP for a subset of individuals and provide a notification of options regarding active selection of an alternative plan and/or, if applicable, making the first month’s premium payment.
2. SBMs report on all applicable applications received and not on the Medicaid-defined cohorts of individuals whose renewal is due in a given month. The data in this table are not cumulative and counts unique Marketplace activities during the reporting period month in which the relevant activity occurs. As such, activities by any one consumer may be included across reporting months. For example, a consumer who submits an application and receives a determination of QHP eligibility may be counted in one month but his/her plan selection could be counted in a later month. Thus, the percentages do not nec