HealthCare.gov Transitions Marketplace Medicaid Unwinding Report

CMS's description

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using HealthCare.gov. Sources: HealthCare.gov application and policy data through October 6, 2024, HealthCare.gov inbound account transfer data through November 7, 2024, and T-MSIS Analytic Files (TAF) through July 2024 (TAF version 7.1). The table includes states that use HealthCare.gov. Notes: This table includes Marketplace consumers who submitted a HealthCare.gov application from March 6, 2023 - October 6, 2024 or who had an inbound account transfer from April 3, 2023 - November 7, 2024, who can be linked to an enrollment record in TAF that shows a last day of Medicaid or CHIP enrollment from March 31, 2023 - July 31, 2024. Beneficiaries with a leaving event may have continuous coverage through another coverage source, including Medicaid or CHIP coverage in another state. However, a beneficiary that lost Medicaid or CHIP coverage and regained coverage in the same state must have a gap of at least 31 days or a full calendar month. This table includes Medicaid or CHIP beneficiaries with full benefits in the month they left Medicaid or CHIP coverage. ‘Account Transfer Consumers Whose Medicaid or CHIP Coverage was Terminated’ are consumers 1) whose full benefit Medicaid or CHIP coverage was terminated and 2) were sent by a state Medicaid or CHIP agency via secure electronic file to the HealthCare.gov Marketplace in a process referred to as an inbound account transfer either 2 months before or 4 months after they left Medicaid or CHIP. 'Marketplace Consumers Not on Account Transfer Whose Medicaid or CHIP Coverage was Terminated' are consumers 1) who applied at the HealthCare.gov Marketplace and 2) were not sent by a state Medicaid or CHIP agency via an inbound account transfer either 2 months before or 4 months after they left Medicaid or CHIP. Marketplace consumers counts are based on the month Medicaid or CHIP coverage was terminated for a beneficiary. Counts include all recent Marketplace activity. HealthCare.gov data are organized by week. Reporting months start on the first Monday of the month and end on the first Sunday of the next month when the last day of the reporting month is not a Sunday. HealthCare.gov data are through Sunday, October 6. Data are preliminary and will be restated over time to reflect consumers most recent HealthCare.gov status. Data may change as states resubmit T-MSIS data or data quality issues are identified. See the data and methodology documentation for a full description of the data sources, measure definitions, and general data limitations. Data notes: The percentages for the 'Marketplace Consumers Not on Account Transfer whose Medicaid or CHIP Coverage was Terminated' data record group are marked as not available (NA) because the full population of consumers without an account transfer was not available for this report. Virginia operated a Federally Facilitated Exchange (FFE) on the HealthCare.gov platform during 2023. In 2024, the state started operating a State Based Marketplace (SBM) platform. This table only includes data about 2023 applications and policies obtained through the HealthCare.gov Marketplace. Due to limited Marketplace activity on the HealthCare.gov platform in November 2023, data from November 2023 onward are excluded. The cumulative count and percentage for Virginia and the HealthCare.gov total reflect Virginia data from April 2023 through October 2023. APTC: Advance Premium Tax Credit; CHIP: Children's Health Insurance Program; QHP: Qualified Health Plan; NA: Not Available

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