The Center for Consumer Information & Insurance Oversight
Health Insurance Marketplace Cost-Sharing Reduction Subsidies by Zip Code and County 2016
The dataset provides the total number of Qualified Health Plan (QHP) selections for individuals receiving cost-sharing reductions, by state, ZIP Code and county for the 38 states that use the HealthCare.gov platform, including the Federally-facilitated Marketplaces, State Partnership Marketplaces, and supported State-based Marketplaces, during the Marketplace’s third Open Enrollment Period (based on data for the period November 1, 2015 – February 1, 2016).
The data represent the net number of unique individuals who have selected a Marketplace plan through one of the 38 states using the Healthcare.gov platform in cost-sharing variants (based on data for the period November 1, 2015 – February 1, 2016), and have a non-cancelled Marketplace plan selection that includes March 2016 coverage.
The 9.63 million plan selections for these 38 states were tabulated by ZIP Code and county according to the home address provided for each individual. Data for ZIP Codes and counties with 1 to 10 plan selections were suppressed due to privacy concerns. Counter or secondary suppression is applied where only one geographic area is suppressed for primary reasons. In these cases, the geographic area with the next smallest count is suppressed as well. A total of 27,765 ZIP Codes and 2,601 counties from the 38 states are listed in the table, which account for 9,625,982 plan selections. ZIP Codes without plan selection data account for less than 0.3 percent of the total 9.63 million plan selections, and Counties without data account for less than 0.01 percent of the total 9.63 million plan selections. Less than 0.1 percent of consumers with CSRs on the county level file and less than 0.6 percent in the ZIP Code file are suppressed.
The sum of plan selections among ZIP Codes and counties within a state using this dataset may not be equal to state-level totals provided in other documents. This is because plan selection counts do not appear for ZIP Codes or counties with 10 or fewer, and as a result the dataset does not include all plan selections within a state. Additionally, in a small number of cases, the state of Marketplace enrollment may not correspond to the state in the address provided — for example, individuals with a seasonal address.
The following information is included within the dataset:
- ZIP Code: the United States Postal Service ZIP Code for the home address provided by the Marketplace applicant.
- County Name: the county name for the home address provided by the Marketplace applicant.
- County FIPS: the county FIPS code for the home address provided by the Marketplace applicant.
- State Name: the state name for the home address provided
- State: the state of residence selected by the Marketplace applicant.
- Plan Selections: the total number of unique individuals who have been determined eligible to enroll in a Qualified Health Plan, have selected a Marketplace plan through one of the 38 states using the Healthcare.gov platform (based on data for the period November 1, 2015 – February 1, 2016), and have a non-cancelled Marketplace plan selection that includes March 2016 coverage. Consumers are counted in the respective CSR category if they had non-cancelled coverage. Individuals in Indian cost-sharing reductions include both individuals in zero and limited cost sharing variants.
- Average Monthly Advanced CSR Payments – The average advanced CSR payment for individuals with non-cancelled coverage in the respective CSR variant. This was calculated as total CSR payments for individuals in the respective CSR variants divided by the total individuals with non-cancelled coverage in the respective income CSR variant.
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