Overlap Between Medicaid Health Plans and QHPs in the Marketplaces: An Examination

With the Health Insurance Marketplaces and Medicaid expansion facing an uncertain future, consumers and insurers alike have expressed concerns about millions losing or being forced to change their health coverage. As of January 22, 2017, more than 11.7 million consumers had enrolled in Qualified Health Plans (QHPs) to provide coverage for 2017, a rate on pace with last year’s totals. Some of these consumers, owing to changes in incomes or other life events, will lose their Marketplace eligibility and gain Medicaid eligibility at some point during the year.

ACAP is interested in better understanding the crossroads of Marketplace and Medicaid coverage. Each year, ACAP identifies all QHP issuers offering coverage and highlights those that also serve as Medicaid MCOs in their states. For simplicity, ACAP refers to these issuers as “overlap issuers.”

Read the study in full (.pdf)

View the spreadsheet (.xls)