The Office of Enterprise Data and Analytics (OEDA), within the Centers for Medicare & Medicaid Services (CMS), has prepared public datasets with the total number of consumers in all 50 states and Washington, DC with Marketplace coverage. The dataset includes consumers with effectuated Health Insurance Marketplace coverage – individuals who paid their premiums and had an active policy on the date of the snapshot. The values include state-level effectuated enrollment, the number of consumers with Applied Premium Tax Credit (APTC) subsidies, and the number of consumers with Cost-Sharing Reduction (CSR) subsidies; state-level effectuated enrollment cut by metal level; and state-level numbers with the average APTC subsidy amount for those consumers receiving APTC.
Individuals 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.