Originally published April 8, 2021. Updated with data through June on July 19, 2021.
CMS data tracking the ACA Special Enrollment Period (SEP) show that Medicaid non-expansion states generally are having higher levels of SEP enrollment activity relative to Medicaid expansion states.
Wisconsin, in terms of SEP enrollment activity, performs similar to other Medicaid expansion states. This likely because Wisconsin’s existing adult Medicaid eligibility is somewhat closer to that of Medicaid expansion states than the much lower level of the other non-expansion states.
One reason that Medicaid non-expansion states might have higher SEP enrollment:
ARPA provides that persons who experienced at least one single week of unemployment in 2021 are now eligible for SEP enrollment and Marketplace subsidies as if their income were 133% FPL, regardless of their actual income.
In the non-expansion states, such residents, who previously might not have been eligible due to falling in the Medicaid gap, (income too high for Medicaid but too low for Marketplace subsidies) may now enroll with Marketplace subsidies via the SEP.
In Wisconsin, substantially more of those residents would be eligible for (and some previously/already enrolled in) adult Medicaid coverage, up to 100% FPL. For them, no SEP enrollment needed.
New Plan Selections by State | Feb. 15 – June 30, 2021 | % Change from 2020 | Feb. 15 – June 30, 2020 | Feb. 15 – June 30, 2019 | Medicaid Expansion State | Parents/Caretaker Adults | Childless Adults |
Hawaii | 3,100 | 31% | 2,373 | 1541 | Yes | 1.38 | 1.38 |
Oregon | 16,625 | 57% | 10,568 | 9,647 | Yes | 1.38 | 1.38 |
Montana | 5,587 | 69% | 3,299 | 2,542 | Yes | 1.38 | 1.38 |
New Hampshire | 6,697 | 77% | 3,786 | 3,166 | Yes | 1.38 | 1.38 |
Wisconsin | 25,772 | 83% | 14,070 | 13,880 | No | 1.00 | 1.00 |
Michigan | 35,632 | 84% | 19,415 | 16,857 | Yes | 1.38 | 1.38 |
Illinois | 40,182 | 85% | 21,682 | 18,735 | Yes | 1.38 | 1.38 |
Maine | 7,478 | 91% | 3,921 | 3,281 | Yes | 1.38 | 1.38 |
Oklahoma | 29,858 | 91% | 15,610 | 11,084 | No | 0.41 | 0 |
West Virginia | 3,031 | 92% | 1,578 | 1239 | Yes | 1.38 | 1.38 |
Nebraska | 11,704 | 93% | 6,054 | 5,220 | Yes | 1.38 | 1.38 |
Indiana | 20,467 | 97% | 10,408 | 9,223 | Yes | 1.38 | 1.38 |
Delaware | 4,479 | 99% | 2,255 | 1623 | Yes | 1.38 | 1.38 |
Iowa | 11,390 | 101% | 5,678 | 4,746 | Yes | 1.38 | 1.38 |
Kentucky | 13,773 | 104% | 6,747 | 7,041 | Yes | 1.38 | 1.38 |
Utah | 32,837 | 112% | 15,515 | 12,778 | Yes | 1.38 | 1.38 |
Ohio | 35,586 | 116% | 16,451 | 13,094 | Yes | 1.38 | 1.38 |
Louisiana | 12,647 | 121% | 5,716 | 6,348 | Yes | 1.38 | 1.38 |
North Dakota | 3,973 | 123% | 1,781 | 1340 | Yes | 1.38 | 1.38 |
Florida | 413,409 | 130% | 179,869 | 120,513 | No | 0.31 | 0 |
Kansas | 15,383 | 138% | 6,462 | 4,918 | No | 0.38 | 0 |
Wyoming | 5,010 | 139% | 2,092 | 1535 | No | 0.52 | 0 |
Virginia | 40,069 | 140% | 16,662 | 15,287 | Yes | 1.38 | 1.38 |
Alaska | 3,080 | 147% | 1247 | 1083 | Yes | 1.38 | 1.38 |
South Dakota | 5,670 | 151% | 2,261 | 1,895 | No | 0.48 | 0 |
Arizona | 29,681 | 153% | 11,742 | 10,376 | Yes | 1.38 | 1.38 |
New Mexico | 6,646 | 153% | 2,625 | 2,428 | Yes | 1.38 | 1.38 |
Tennessee | 41,683 | 161% | 15,961 | 9,310 | No | 0.93 | 0 |
Arkansas | 14,228 | 171% | 5,245 | 4,970 | Yes | 1.38 | 1.38 |
Missouri | 37,844 | 175% | 13,758 | 9,185 | No | 0.21 | 0 |
North Carolina | 91,166 | 179% | 32,697 | 23,634 | No | 0.41 | 0 |
Alabama | 30,845 | 183% | 10,916 | 7,339 | No | 0.18 | 0 |
Mississippi | 22,546 | 188% | 7,836 | 4,406 | NO | 0.25 | 0 |
Texas | 293,760 | 194% | 99,911 | 52,941 | No | 0.17 | 0 |
South Carolina | 43,993 | 205% | 14,406 | 8,844 | No | 0.67 | 0 |
Georgia | 106,452 | 208% | 34,586 | 20,967 | No | 0.35 | 0 |
Read the full article at: https://www.cms.gov/newsroom/fact-sheets/2021-marketplace-special-enrollment-period-report-3