As enrollment opened for health insurance Marketplaces in 2013 for the 2014 benefit year, the Association for Community Affiliated Plans (ACAP) set out to identify all Qualified Health Plan (QHP) issuers by researching a variety of sources. In particular, ACAP wished to identify how many QHP issuers also served as Medicaid managed care organizations (MCOs) in each state. For simplicity, these
issuers will be referred to as “overlap issuers.” This overlap could be an asset in limiting the impact of “churn,” the term for enrollees entering and exiting coverage due to unforeseen loss of coverage. Marketplace and Medicaid churn can be caused by minor fluctuations in income, and movement of individuals between these two coverage settings is expected to be substantial. Historically, miscellaneous clerical errors, failure to renew enrollment on a timely basis, and other factors have contributed to significant amounts of churn in the Medicaid program.

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