SEP enrollment: Wisconsin lower activity, performing more like Medicaid expansion states

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