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March 31, 2016 Effectuated Enrollment Snapshot

Date
2016-06-30
Title
March 31, 2016 Effectuated Enrollment Snapshot
Contact
press@cms.hhs.gov

March 31, 2016 Effectuated Enrollment Snapshot

On March 31, 2016, about 11.1 million consumers had effectuated Health Insurance Marketplace coverage – which means those individuals, paid their premiums and had an active policy as of that date.i HHS continues to project effectuated enrollment of about 10 million people for the end of 2016.

Of the approximately 11.1 million consumers nationwide with effectuated Marketplace enrollments at the end of March 2016, about 85 percent, or about 9.4 million consumers, were receiving an advance payment of the premium tax credit (APTC) to make their premiums more affordable throughout the year. The average APTC for those enrollees who qualified for the financial assistance was $291 per month.ii

There were 8.4 million consumers with effectuated enrollments at the end of March 2016 through the 38 Federally-Facilitated Marketplaces, including State Partnership Marketplaces and State-based Marketplaces that utilize the HealthCare.gov eligibility and enrollment platform (SBM-FPs), collectively known as HealthCare.gov states and 2.7 million through the remaining State-based Marketplaces.iii

As of the end of March 2016, about 11.1 million people had health insurance coverage through the Health Insurance Marketplaces, almost a million more than at this point in time a year ago. “This increased level of enrollment demonstrates the strength of the Marketplace over time, as millions of Americans continue to have access to quality and affordable coverage when they need it. As of early this year, 20 million Americans had coverage thanks to provisions of the Affordable Care Act, and the Health Insurance Marketplace is an important contributor to that progress,” said Kevin Counihan, CEO of the Health Insurance Marketplace.

March effectuated enrollment equaled 87 percent of total Open Enrollment plan selections, within the 80-90 percent range that Marketplace issuers have consistently anticipated and the same percentage as last year, despite factors that might have been expected to lower the percentage. For example, a higher proportion of consumers this year signed up for January 1 coverage, creating a longer window between their initial plan selection and March in which they could have gained employer or other coverage.

To date, CMS has released Marketplace state-by-state effectuated enrollment snapshots on a quarterly basis, detailing how many consumers have an effectuated enrollment, how many are benefiting from financial assistance, and the distribution of effectuated enrollment by qualified health plan metal level. Changes in effectuated enrollment are influenced by many factors and vary from quarter to quarter, and have been reported based on data gathered by the original payment systems set up when the Marketplace launched.

The Marketplace effectuated enrollment snapshot provides point-in-time estimates. CMS expects enrollment numbers will change over time as consumers find other coverage or experience changes in life circumstances such as employment status or marriage, which may cause consumers to change, newly enroll in, or terminate their plans.

Moving forward, CMS will be reporting effectuated enrollment data semiannually, once for the first six months of the year and once for the full twelve months of the year, based on the average number of effectuated enrollments over the relevant time period. Average effectuated enrollment provides a more meaningful metric of Marketplace participation, since it captures all enrollments over the time period, rather than only enrollment at a particular point in time.  The new reporting will also facilitate comparisons to projections made by the Congressional Budget Office, which reflect average enrollment throughout the year.  As issuers fully transition to a new payment system using policy-based data, rather than issuer-aggregated workbook-based reporting, the new payment system offers the opportunity to conduct more refined enrollment reporting. We expect to issue the first semiannual effectuated enrollment report in the fall.

Along with this effectuated enrollment report, we are also releasing an addendum (below) providing updated data on special enrollment period activity in 2015, as well as an analysis of the reduction in the number of consumers experiencing coverage terminations or adjustments to financial assistance due to unresolved data-matching issues.

The following tables are included in the March 2016 Marketplace Effectuated Enrollment Snapshot:

Table 1: March 31, 2016 Total Effectuated Enrollment and Financial Assistance by State
Table 2: March 31, 2016 Average Advance Payment of Tax Credits by State
Table 3: March 31, 2016 Total Effectuated Enrollment Data by Metal Level by State

March 2016: Total Effectuated Enrollment and Financial Assistance

Of the approximately 11.1 million consumers who had effectuated Marketplace enrollments at the end of March 2016, about 85 percent or about 9.4 million consumers were receiving APTC,iv 57 percent or nearly 6.4 million consumers were benefiting from cost sharing reductions (CSRs) to make their coverage more affordable. CSRs are generally available if a consumer’s household income is between 100 percent and 250 percent of the Federal Poverty Level (FPL), the consumer is otherwise eligible for APTC, and the individual chooses a health plan from the silver plan category.

The ten states with the highest rate of consumers who received financial assistance through APTC were: Mississippi (94.2%), Florida (93.3%), Louisiana (92.6%), Wyoming (92.0%), Alabama (91.9%), North Carolina (91.5%), South Carolina (91.0%), Alaska (90.1%), Nebraska (89.9%), and Arkansas (89.7%). The states with the lowest rate of consumers who received APTC are: District of Columbia (6.9%), New York (55.3%), Colorado (61.9%), New Hampshire (63.4%), Minnesota (63.8%), New Mexico (68.9%), Arizona (69.3%), Washington (69.8%), Vermont (70.2%), and Oregon (72.8%).

Table 1: March 31, 2016 Total Effectuated Enrollment and Financial Assistance by State 

 March 31, 2016
Total Effectuated Enrollment and Financial Assistance by State

State

Total
Enrollment

APTC
Enrollment

Percentage of
Enrollment
with APTC

CSR Enrollment

Percentage of
Enrollment
with CSR

Total

11,081,330

9,389,609

84.7%

6,353,551

57.3%

Alabama

165,534

152,206

91.9%

125,424

75.8%

Alaska

17,995

16,205

90.1%

7,500

41.7%

Arizona

179,445

124,346

69.3%

94,463

52.6%

Arkansas

63,357

56,843

89.7%

36,134

57.0%

California

1,415,428

1,239,893

87.6%

707,671

50.0%

Colorado

108,311

67,062

61.9%

28,929

26.7%

Connecticut

102,917

80,759

78.5%

52,132

50.7%

Delaware

25,379

21,467

84.6%

11,146

43.9%

District of Columbia

17,666

1,224

6.9%

279

1.6%

Florida

1,531,714

1,428,712

93.3%

1,125,850

73.5%

Georgia

478,016

427,353

89.4%

322,348

67.4%

Hawaii

13,313

10,958

82.3%

8,067

60.6%

Idaho

94,270

82,802

87.8%

58,781

62.4%

Illinois

335,243

259,701

77.5%

156,469

46.7%

Indiana

168,884

139,437

82.6%

77,251

45.7%

Iowa

48,949

42,595

87.0%

25,677

52.5%

Kansas

89,566

75,815

84.6%

53,034

59.2%

Kentucky

74,640

56,488

75.7%

32,186

43.1%

Louisiana

184,403

170,806

92.6%

118,597

64.3%

Maine

75,240

63,896

84.9%

42,880

57.0%

Maryland

135,208

100,844

74.6%

72,175

53.4%

Massachusetts

207,121

157,751

76.2%

132,721

64.1%

Michigan

313,123

275,080

87.9%

164,725

52.6%

Minnesota

74,060

47,266

63.8%

12,128

16.4%

Mississippi

77,747

73,246

94.2%

60,354

77.6%

Missouri

252,044

225,878

89.6%

148,033

58.7%

Montana

51,758

44,091

85.2%

23,479

45.4%

Nebraska

80,213

72,091

89.9%

41,950

52.3%

Nevada

79,876

71,472

89.5%

48,736

61.0%

New Hampshire

49,114

31,151

63.4%

17,376

35.4%

New Jersey

249,395

205,242

82.3%

129,277

51.8%

New Mexico

47,497

32,703

68.9%

22,655

47.7%

New York

224,014

123,830

55.3%

40,544

18.1%

North Carolina

545,354

499,178

91.5%

360,045

66.0%

North Dakota

20,536

17,630

85.8%

9,199

44.8%

Ohio

212,046

174,448

82.3%

95,312

44.9%

Oklahoma

130,178

113,209

87.0%

81,053

62.3%

Oregon

131,167

95,507

72.8%

52,960

40.4%

Pennsylvania

412,347

321,345

77.9%

227,304

55.1%

Rhode Island

35,583

30,015

84.4%

21,270

59.8%

South Carolina

204,846

186,345

91.0%

150,030

73.2%

South Dakota

24,578

22,005

89.5%

15,108

61.5%

Tennessee

231,705

203,112

87.7%

138,272

59.7%

Texas

1,092,650

913,177

83.6%

646,415

59.2%

Utah

164,415

145,288

88.4%

106,589

64.8%

Vermont

27,883

19,575

70.2%

9,751

35.0%

Virginia

378,838

319,068

84.2%

222,233

58.7%

Washington

158,245

110,476

69.8%

66,083

41.8%

West Virginia

33,235

29,163

87.7%

17,414

52.4%

Wisconsin

224,208

190,542

85.0%

123,307

55.0%

Wyoming

22,076

20,313

92.0%

12,235

55.4%

 

March 2016: Average APTC by State

Consumers with household incomes between 100 percent and 400 percent of the FPL may qualify for APTC, which helps make their coverage more affordable throughout the year by lowering their share of monthly premium costs. Consumers who qualify for APTC may choose how much of the APTC to apply to their premiums each month, up to the maximum amount for which they are eligible.

The overall average APTC Marketplace consumers received was $291 per month at the end of March 2016. Because the amount of APTC an enrollee may receive depends on household income and the cost of the second lowest cost Silver plan available to the enrollee, the average APTC ranged from $750 per month in Alaska to $178 per month in New York.

 

Table 2: March 31, 2016 Average Advance Payment of Tax Credits by State

March 2016
Average Advanced Premium Tax Credit by State
(for individuals receiving APTC)

State

Average APTC per Month
(for all APTC enrollees)

National Average

$291

Alabama

$310

Alaska

$750

Arizona

$230

Arkansas

$306

California

$309

Colorado

$318

Connecticut

$357

Delaware

$330

District of Columbia

$183

Florida

$305

Georgia

$291

Hawaii

$270

Idaho

$265

Illinois

$237

Indiana

$259

Iowa

$307

Kansas

$247

Kentucky

$258

Louisiana

$362

Maine

$342

Maryland

$243

Massachusetts

$190

Michigan

$233

Minnesota

$203

Mississippi

$306

Missouri

$315

Montana

$306

Nebraska

$296

Nevada

$268

New Hampshire

$261

New Jersey

$322

New Mexico

$212

New York

$178

North Carolina

$401

North Dakota

$262

Ohio

$250

Oklahoma

$298

Oregon

$253

Pennsylvania

$248

Rhode Island

$250

South Carolina

$312

South Dakota

$307

Tennessee

$299

Texas

$271

Utah

$187

Vermont

$300

Virginia

$276

Washington

$238

West Virginia

$388

Wisconsin

$332

Wyoming

$459

 

March 2016: Total Effectuated Enrollment by Metal Level by State

There are four “metal levels” of coverage available through the Marketplace, plus catastrophic plans. Plans in each category can be expected to pay different amounts of the total costs of an average person’s care. This takes into account the plans’ deductibles, copayments, coinsurance, and out-of-pocket maximums. The actual percentage a consumer pays in total or per service will depend on the services used during the year.

  • Catastrophic: The health plan pays less than 60% of the total average cost of care on average, with consumers paying the balance. These plans are only available to people who are under 30 years old at the beginning of the plan year, or those who have a hardship or affordability exemption.
  • Bronze: The health plan pays about 60% and consumer pays about 40%, on average.
  • Silver: The health plan pays about 70% and consumer pays about 30%, on average. Consumers eligible for CSRs can only receive them by enrolling in a silver plan. (Note, American Indians and Alaska Natives can receive CSRs through any metal-level plan.)
  • Gold: The health plan pays about 80% and consumer pays about 20%, on average.
  • Platinum: The health plan pays about 90% and consumer pays about 10%, on average.

Of the approximately 11.1 million consumers with effectuated enrollment in Marketplace plans at the end of March 2016, less than half a percent were enrolled in Catastrophic plans, 22% were enrolled in Bronze plans, 70% enrolled in Silver plans, 6% enrolled in Gold plans, and 2% enrolled in Platinum plans.

Table 3: March 31, 2016 Total Effectuated Enrollment Data by Metal Level by State

March 2016
Total Effectuated Enrollment by Metal Level

State

Metal Level

Enrollees

Total

Total

11,081,330

Total

Bronze

2,427,537

Total

Catastrophic

67,807

Total

Gold

697,157

Total

Platinum

166,846

Total

Silver

7,721,983

Alabama

Bronze

11,966

Alabama

Catastrophic

1,579

Alabama

Gold

7,068

Alabama

Platinum

621

Alabama

Silver

144,300

Alaska

Bronze

8,476

Alaska

Catastrophic

82

Alaska

Gold

584

Alaska

Silver

8,853

Arizona

Bronze

39,297

Arizona

Catastrophic

3,345

Arizona

Gold

19,915

Arizona

Platinum

1,180

Arizona

Silver

115,708

Arkansas

Bronze

12,299

Arkansas

Catastrophic

348

Arkansas

Gold

6,046

Arkansas

Silver

44,664

California

Bronze

379,710

California

Catastrophic

288

California

Gold

71,548

California

Platinum

54,273

California

Silver

909,609

Colorado

Bronze

49,815

Colorado

Gold

7,790

Colorado

Platinum

947

Colorado

Silver

49,759

Connecticut

Bronze

22,981

Connecticut

Catastrophic

1,327

Connecticut

Gold

12,892

Connecticut

Platinum

1,449

Connecticut

Silver

64,268

Delaware

Bronze

5,503

Delaware

Catastrophic

94

Delaware

Gold

3,413

Delaware

Platinum

680

Delaware

Silver

15,689

District of Columbia

Bronze

4,798

District of Columbia

Catastrophic

890

District of Columbia

Gold

3,536

District of Columbia

Platinum

2,757

District of Columbia

Silver

5,685

Florida

Bronze

224,732

Florida

Catastrophic

7,166

Florida

Gold

59,095

Florida

Platinum

21,497

Florida

Silver

1,219,224

Georgia

Bronze

74,007

Georgia

Catastrophic

5,293

Georgia

Gold

26,081

Georgia

Silver

372,635

Hawaii

Bronze

2,036

Hawaii

Catastrophic

28

Hawaii

Gold

1,001

Hawaii

Platinum

830

Hawaii

Silver

9,418

Idaho

Bronze

21,573

Idaho

Catastrophic

772

Idaho

Gold

6,889

Idaho

Silver

65,036

Illinois

Bronze

97,365

Illinois

Catastrophic

1,313

Illinois

Gold

33,444

Illinois

Silver

203,121

Indiana

Bronze

57,689

Indiana

Catastrophic

685

Indiana

Gold

8,003

Indiana

Silver

102,507

Iowa

Bronze

13,626

Iowa

Catastrophic

73

Iowa

Gold

2,906

Iowa

Platinum

14

Iowa

Silver

32,330

Kansas

Bronze

18,766

Kansas

Gold

6,931

Kansas

Platinum

1,287

Kansas

Silver

62,582

Kentucky

Bronze

20,205

Kentucky

Gold

8,000

Kentucky

Platinum

42

Kentucky

Silver

46,393

Louisiana

Bronze

36,891

Louisiana

Catastrophic

898

Louisiana

Gold

10,185

Louisiana

Platinum

2,107

Louisiana

Silver

134,322

Maine

Bronze

16,796

Maine

Catastrophic

519

Maine

Gold

3,598

Maine

Silver

54,327

Maryland

Bronze

30,980

Maryland

Catastrophic

2,230

Maryland

Gold

10,754

Maryland

Platinum

1,074

Maryland

Silver

90,170

Massachusetts

Bronze

7,224

Massachusetts

Catastrophic

650

Massachusetts

Gold

9,741

Massachusetts

Platinum

5,716

Massachusetts

Silver

183,790

Michigan

Bronze

78,137

Michigan

Catastrophic

2,755

Michigan

Gold

18,482

Michigan

Platinum

2,617

Michigan

Silver

211,132

Minnesota

Bronze

36,136

Minnesota

Catastrophic

864

Minnesota

Gold

11,252

Minnesota

Silver

25,808

Mississippi

Bronze

9,022

Mississippi

Catastrophic

463

Mississippi

Gold

2,376

Mississippi

Platinum

525

Mississippi

Silver

65,361

Missouri

Bronze

65,626

Missouri

Catastrophic

910

Missouri

Gold

12,654

Missouri

Platinum

708

Missouri

Silver

172,146

Montana

Bronze

20,263

Montana

Catastrophic

458

Montana

Gold

2,665

Montana

Silver

28,372

Nebraska

Bronze

26,563

Nebraska

Catastrophic

935

Nebraska

Gold

3,202

Nebraska

Silver

49,513

Nevada

Bronze

17,253

Nevada

Catastrophic

449

Nevada

Gold

3,782

Nevada

Platinum

1,662

Nevada

Silver

56,730

New Hampshire

Bronze

16,807

New Hampshire

Catastrophic

797

New Hampshire

Gold

4,784

New Hampshire

Platinum

620

New Hampshire

Silver

26,106

New Jersey

Bronze

37,256

New Jersey

Catastrophic

767

New Jersey

Gold

20,084

New Jersey

Platinum

5,200

New Jersey

Silver

186,088

New Mexico

Bronze

9,864

New Mexico

Catastrophic

244

New Mexico

Gold

6,952

New Mexico

Platinum

288

New Mexico

Silver

30,149

New York

Bronze

55,734

New York

Catastrophic

1,816

New York

Gold

35,213

New York

Platinum

39,401

New York

Silver

91,850

North Carolina

Bronze

91,622

North Carolina

Catastrophic

5,958

North Carolina

Gold

17,964

North Carolina

Platinum

3,261

North Carolina

Silver

426,549

North Dakota

Bronze

5,063

North Dakota

Catastrophic

453

North Dakota

Gold

4,354

North Dakota

Silver

10,666

Ohio

Bronze

71,050

Ohio

Catastrophic

2,490

Ohio

Gold

15,734

Ohio

Platinum

514

Ohio

Silver

122,258

Oklahoma

Bronze

37,657

Oklahoma

Catastrophic

144

Oklahoma

Gold

5,943

Oklahoma

Silver

86,434

Oregon

Bronze

36,471

Oregon

Catastrophic

1,059

Oregon

Gold

13,166

Oregon

Silver

80,471

Pennsylvania

Bronze

59,995

Pennsylvania

Catastrophic

2,272

Pennsylvania

Gold

44,686

Pennsylvania

Platinum

6,107

Pennsylvania

Silver

299,287

Rhode Island

Bronze

6,696

Rhode Island

Gold

3,948

Rhode Island

Silver

24,939

South Carolina

Bronze

15,586

South Carolina

Catastrophic

1,148

South Carolina

Gold

7,704

South Carolina

Silver

180,408

South Dakota

Bronze

4,708

South Dakota

Catastrophic

268

South Dakota

Gold

1,040

South Dakota

Silver

18,562

Tennessee

Bronze

58,967

Tennessee

Catastrophic

1,565

Tennessee

Gold

7,470

Tennessee

Platinum

973

Tennessee

Silver

162,730

Texas

Bronze

283,356

Texas

Catastrophic

5,462

Texas

Gold

61,993

Texas

Platinum

4,016

Texas

Silver

737,823

Utah

Bronze

23,209

Utah

Catastrophic

445

Utah

Gold

17,355

Utah

Platinum

622

Utah

Silver

122,784

Vermont

Bronze

5,414

Vermont

Catastrophic

315

Vermont

Gold

2,594

Vermont

Platinum

2,702

Vermont

Silver

16,858

Virginia

Bronze

81,533

Virginia

Catastrophic

5,112

Virginia

Gold

24,402

Virginia

Platinum

1,452

Virginia

Silver

266,339

Washington

Bronze

54,015

Washington

Catastrophic

1,379

Washington

Gold

13,175

Washington

Silver

89,676

West Virginia

Bronze

6,294

West Virginia

Catastrophic

79

West Virginia

Gold

3,571

West Virginia

Silver

23,291

Wisconsin

Bronze

50,540

Wisconsin

Catastrophic

1,536

Wisconsin

Gold

10,425

Wisconsin

Platinum

1,704

Wisconsin

Silver

160,003

Wyoming

Bronze

5,965

Wyoming

Catastrophic

84

Wyoming

Gold

767

Wyoming

Silver

15,260

 

2016 Data Matching

In operating the Marketplace, we are committed to providing access to coverage and financial assistance to individuals and families who are eligible while maintaining strong program integrity protections. Throughout 2014, 2015, and into 2016, the Marketplace has worked to resolve consumers’ data matching issues, including for those individuals whose citizenship, immigration status, or household income application information did not match information in our trusted data sources.For various timing and operational reasons, data matching actions were more concentrated in the first quarter during 2015 than they are likely to be this year. Thus, we do not expect a comparable reduction in data matching issues going forward. Nonetheless, with such a strong start, we do anticipate substantial progress for the year as a whole.

The Marketplace takes regular, monthly action for consumers with unresolved data matching issues who have not provided adequate documentation within 95 days for citizenship or immigration status data matching issues and within 90 days for household income inconsistencies. Consumers who do not submit sufficient documentation to resolve their annual household income data matching issue will have a recalculation of their APTC and/or CSRs based on available tax data. Individuals who have not provided the necessary documentation for their citizenship or immigration status will have their enrollment through the Marketplace terminated. Those individuals whose enrollment through the Marketplace was terminated because of citizenship or immigration status data matching issues are not included in effectuated enrollment totals.

During the time period from January 1, 2016 to March 31, 2016, enrollment in coverage through the Federally-facilitated Marketplace was terminated for about 17,000 consumers with unresolved citizenship or immigration status data matching issues. During the same time period, 73,000 households with unresolved annual household income data matching issues had their APTC and/or CSRs for 2016 coverage adjusted.  Compared to the first quarter of last year, this represents an 85 percent decrease in the number of consumers whose coverage ended because of an unresolved citizenship or immigration data matching issue, and a 69 percent decrease in households with income data matching issues who had their advanced payment of the premium tax credit and/or their cost sharing reduction adjusted.

If consumers believe they have the appropriate documentation but their enrollment through the Marketplace was terminated based on a citizenship/immigration status data matching issue, they are able to submit their documentation to the Marketplace to resolve the data matching issue and regain enrollment through the Marketplace through a Special Enrollment Period.

Addendum Report: Special Enrollment Period Sign ups in 2015 

In the Health Insurance Marketplace, most consumers select a plan during the annual Open Enrollment Period.  Consumers who experience one of six types of life events can also select a plan during a special enrollment period.  For states on the HealthCare.gov platform during 2015, 1.6 million individuals who did not select a plan during open enrollment made a plan selection through a special enrollment period (SEP). 

The majority of these consumers (60 percent) received a special enrollment period for loss of minimum essential coverage. This means the consumer enrolled in Marketplace coverage after losing other health insurance, like coverage from their job. In addition, 18 percent of SEP plan selections were made by consumers who initially applied for coverage during open enrollment but needed to receive an eligibility determination from their state Medicaid agency before they could be determined eligible for Marketplace coverage and/or financial assistance. The tax season SEP for 2015 accounted for 9 percent of SEP plan selections. The tax SEP was not available for 2016. Finally, small numbers of consumers enrolled for other reasons, including birth, adoption, marriage, a move, or other circumstances. 

These figures include only consumers who did not have a plan selection during open enrollment; a consumer who enrolled during open enrollment and used an SEP to change plans is not reflected here. 

 

 

 

Table 1: Distribution of SEP Reasons among 2015 Consumers with a Plan Selection Outside of the OE2 Baseline Population

SEP Reason

Count of Plan Selections

% of Plan Selections

Minimum Essential Coverage (MEC) loss

959,714

59.50%

Applicant attested to being denied Medicaid

286,266

17.70%

2015 Tax SEP

152,251

9.40%

Moved to a new service area

57,836

3.60%

Exceptional Circumstance

54,641

3.40%

Other SEPs

54,469

3.40%

Baby born in household

30,973

1.90%

Granted for marriage in household

14,692

0.90%

Granted for adoption in household

3,268

0.20%

Total

1,614,110

100.0%



i effectuate their enrollment by paying their first month’s premium. This snapshot measures individuals who effectuated their enrollment and have an active policy on the date of the snapshot; it does not measure the rate at which consumers pay their first month’s premium. Active policies include those who have paid for the current month and individuals who may be in a grace period for non-payment. Grace periods can vary by state and issuer. For those individuals receiving APTC, issuers are required to give enrollees a three month grace period. 45 CFR §§ 155.430 and 156.270.
ii This data is reported by insurance companies with plans in the Health Insurance Marketplaces as part of the interim payment process. Issuers report total effectuated enrollment counts, and the estimated APTC amounts owed to the issuer for those effectuated enrollments. After CMS validates these amounts, issuers are paid monthly based on these estimates. Each month, issuers are permitted to restate prior months’ enrollment and payment data to reflect enrollee cancellations, terminations, or other fluctuations in enrollment. The data in this snapshot represents issuer estimates of individuals with effectuated enrollment for March 2016 as of the May 2016 interim payment process data submission.
iii For 2016, there are 38 HealthCare.gov states; including, Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.  Hawaii, New Mexico, Nevada, and Oregon are State-based Marketplaces using the HealthCare.gov platform for 2016. Thirteen states – California, Colorado, Connecticut, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont and Washington – plus the District of Columbia – have their own State-based Marketplaces and are using their own technology platform for 2016.

iv Consumers reconcile differences between their projected 2016 household income and their actual household income to determine the final premium tax credits they should receive. This reconciliation process ensures individuals receive the correct amount of tax credit, which will be reflected on their tax return: taxpayers may see a smaller refund or owe money back if they underestimated their household income, or they may get a bigger refund if they overestimated their household income.