State-By-State Information

This page has all of the information you need about your state’s progress in Insurance Marketplace development and Medicaid expansion decision.

Coverage through the Marketplaces began in every state on January 1, 2014. The fourth open enrollment period runs from November 1, 2016 through January 31, 2017.

State-By-State Insurance Marketplaces

Definitions

State-based Marketplace: States running a State-based Marketplace are responsible for performing all Marketplace functions for both the individual market and the Small Business Health Options Program (SHOP). Consumers as well as small employers and their employees in these states apply for and enroll in coverage through Marketplace websites established and maintained by the states.

State-based Marketplace-Federal Platform: States with this type of Marketplace are considered to have a State-based Marketplace, and are responsible for performing all Marketplace functions for the individual market and the SHOP, except that the state will rely on the Federally-facilitated Marketplace IT platform. Consumers as well as small employers and their employees in these states apply for and enroll in coverage through healthcare.gov.

State-Partnership Marketplace States entering into a Partnership Marketplace conduct plan management and may administer in-person consumer assistance; HHS performs the remaining Marketplace functions. Consumers as well as small employers and their employees in states with a Partnership Marketplace apply for and enroll in coverage through healthcare.gov.

Federally-facilitated Marketplace: In a Federally-facilitated Marketplace, HHS performs all Marketplace functions. Consumers as well as small employers and their employees in states with a Federally-facilitated Marketplace apply for and enroll in coverage through healthcare.gov.

*Indicates states with federally recognized tribes.
Chart last updated November 7, 2017

For more information about Insurance Marketplaces, click here.

State-By-State Medicaid Expansion in 2017

Some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. Others haven’t.

Whether you qualify for Medicaid coverage depends partly on whether your state has expanded its program.

  • In all states: You can qualify for Medicaid based on income, household size, disability, family status, and other factors. Eligibility rules differ between states.
  • In states that have expanded Medicaid coverage: You can qualify based on your income alone. If your household income is below 133% of the federal poverty level, you qualify. (Because of the way this is calculated, it turns out to be 138% of the federal poverty level. A few states use a different income limit.)

 

For more information about Medicaid expansion, click here.