Health Insurance Exchanges Annual Effectuated Enrollment
The Health Insurance Exchanges Annual Effectuated Enrollment data provide select metrics on annual average effectuated enrollment across the Federally Facilitated Exchange (FFE) and State Based Exchanges on the Federal...
Freshness
- Last posted
- Period covered
- Jan 1, 2025 to Dec 31, 2025
- Update frequency
- Annually
Dates as CMS lists them in its catalog.
Columns 11
| Column | What it means | Type |
|---|---|---|
StateState | Two‑letter state code for grouping effectuated enrollment by state. Includes “Total” values indicating platform‑level enrollment totals (all platforms, HealthCare.gov, and State‑Based Exchanges). | string |
YearYear | Specifies the coverage year for which effectuated enrollment data is reported. | string |
PlatformPlatform | Indicates the individual insurance marketplace model the state participates in. Values include "All," which represents all marketplace platforms; "HealthCare.gov," which includes Federally Facilitated Exchanges (FFE) and State‑Based Exchanges on the Federal Platform (SBE‑FPs); and "SBE," which represents State‑Based Exchanges that operate their own Exchange and conduct eligibility determinations, enrollment, and other related functions. | string |
Effectuated EnrollmentEffectuated_Enr | Average monthly effectuated enrollment is the average monthly number of individuals with active policies at any point between January and December of the indicated year, who also paid their premiums, if applicable. The average monthly effectuated enrollment was calculated by adding total member months for the indicated year and dividing by twelve. | number |
Advanced Premium Tax Credit (APTC) EnrollmentAPTC_Enr | The average monthly number of individuals with active policies at any point between January and December of the indicated coverage year, who also paid their premium (if applicable) and received APTC in association with their active policies in the indicated year. | number |
Percentage of Enrollment with APTCPct_APTC_Enr | The average monthly number of APTC enrollees divided by the average monthly total enrollment for the respective state. | number |
Cost-Sharing Reductions (CSR) EnrollmentCSR_Enr | The average number of individuals with active policies at any point between January and December of the indicated coverage year who also paid their premium (if applicable) and received CSR in association with their active policies in the indicated coverage year. | number |
Percentage of Enrollment with CSRPct_CSR_Enr | The average monthly number of CSR enrollees divided by the average monthly total enrollment for the respective state. | number |
Average Total Premium per MonthAvg_Prm | The sum of total monthly premium amounts across all months in the indicated coverage year, divided by the sum of total monthly member counts across all months in the indicated coverage year. | number |
Average APTC per Month (for Consumers receiving APTC)Avg_APTC | The sum of total monthly APTC amounts across all months in the indicated coverage year, divided by the sum of total monthly APTC member counts across all months in the indicated coverage year. | number |
Average Premium after APTC per MonthAvg_Prm_Aft_APTC | The sum of total monthly premium amounts across all months in the indicated coverage year, minus the sum of total monthly APTC amounts across all months in the indicated coverage year, divided by the sum of total monthly member counts across all months in the indicated coverage year. | number |
No column matches that filter.
At a glance
- Catalog
- data.cms.gov
- Publisher
- Office of Enterprise Data and Analytics (OEDA)
- Rows
- 540
- Columns
- 11
- State column
State- Topics
- Medicare enrollment
- Contact
- CCIIOwebpages@cms.hhs.gov
API
Free, no key needed. This request returns the first 10 rows as JSON:
https://data.cms.gov/data-api/v1/dataset/05979174-881c-4504-8d9b-a2edf61d5a47/data?size=10
To keep only one state, filter on the State column.
CMS's description
The Health Insurance Exchanges Annual Effectuated Enrollment data provide select metrics on annual average effectuated enrollment across the Federally Facilitated Exchange (FFE) and State Based Exchanges on the Federal Platform (SBE-FPs), which both use the federal enrollment platform (HealthCare.gov), as well as State Based Exchanges (SBEs) that operate their own eligibility and enrollment platforms. These metrics include average effectuated enrollment, the average number of consumers with Advanced Premium Tax Credit (APTC) subsidies, the average number of consumers with Cost Sharing Reduction (CSR) subsidies, and the average APTC subsidy amount for consumers receiving APTC, at the state level.
Methodology and other documents from CMS:
The summary at the top is the first sentence of this description. Record id cms:05979174-881c-4504-8d9b-a2edf61d5a47. This record as JSON.