Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using HealthCare.gov. As of August 2024, CMS is no longer releasing the “HealthCare.gov” metrics. Historical data between July 2023-July 2024 will remain available. The “HealthCare.gov Transitions” metrics, which are the CAA, 2023 required metrics, will continue to be released.
Sources: HealthCare.gov application and policy data through May 5, 2024, and T-MSIS Analytic Files (TAF) through March 2024 (TAF version 7.1 with T-MSIS enrollment through the end of March 2024). Data include consumers in HealthCare.gov states where the first unwinding renewal cohort is due on or after the end of reporting month (state identification based on HealthCare.gov policy and application data). State data start being reported in the month when the state's first unwinding renewal cohort is due. April data include Arizona, Arkansas, Florida, Indiana, Iowa, Kansas, Nebraska, New Hampshire, Ohio, Oklahoma, South Dakota, Utah, West Virginia, and Wyoming. May data include the previous states and the following new states: Alaska, Delaware, Georgia, Hawaii, Montana, North Dakota, South Carolina, Texas, and Virginia. June data include the previous states and the following new states: Alabama, Illinois, Louisiana, Michigan, Missouri, Mississippi, North Carolina, Tennessee, and Wisconsin. July data include the previous states and Oregon. All HealthCare.gov states are included in this version of the report.
Notes:

1. This table includes Marketplace consumers who: 1) submitted a HealthCare.gov application on or after the start of each state’s first reporting month; and 2) who can be linked to an enrollment record in TAF that shows Medicaid or CHIP enrollment between March 2023 and the latest reporting month.
2. Cumulative counts show the number of unique consumers from the included population who had a Marketplace application submitted or a HealthCare.gov Marketplace policy on or after the start of each state’s first reporting month through the latest reporting month. Net counts show the difference between the cumulative counts through a given reporting month and previous reporting months.
3. The data used to produce the metrics are organized by week. Reporting months start on the first Monday of the month and end on the first Sunday of the next month when the last day of the reporting month is not a Sunday. For example, the April 2023 reporting period extends from Monday, April 3 through Sunday, April 30.
4. Data are preliminary and will be restated over time to reflect consumers most recent HealthCare.gov status. Data may change as states resubmit T-MSIS data or data quality issues are identified.
5. Data do not represent Marketplace consumers who had a confirmed Medicaid/CHIP loss. Future reporting will look at coverage transitions for people who lost Medicaid/CHIP.
6. See the data and methodology documentation for a full description of the data sources, measure definitions, and general data limitations.

Data notes:

1. Virginia operated a Federally Facilitated Exchange (FFE) on the HealthCare.gov platform during 2023. In 2024, the state started operating a State Based Marketplace (SBM) platform. This table only includes data on 2023 applications and policies obtained through the HealthCare.gov Marketplace. Due to limited Marketplace activity on the HealthCare.gov platform in December 2023, data from December 2023 onward are excluded. The cumulative count and percentage for Virginia and the HealthCare.gov total reflect Virginia data from April 2023 through November 2023.
2. The report may include negative 'net counts,' which reflect that there were cumulatively fewer counts from one month to the next.
3. Wyoming has negative ‘net counts’ for most of its metrics in March 2024, including 'Marketplace Consumers with Previous Medicaid or CHIP Enrollment.' Negative counts reflect that there were cumulatively fewer individual counts from one month to the next. The net percentages have been replaced with an asterisk for March 2024 due to the uninterpretable values.

Percentages shown are of total Marketplace consumers with previous Medicaid or CHIP enrollment.
Some cells have a value of "NR" or not reported. State data starts being reported in the month when the state's first unwinding renewal cohort is due.

APTC: Advance Premium Tax Credit; CHIP: Children's Health Insurance Program; NR: Not reported; QHP: Qualified Health Plan

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using HealthCare.gov.
Sources: HealthCare.gov application and policy data through October 6, 2024, HealthCare.gov inbound account transfer data through November 7, 2024, and T-MSIS Analytic Files (TAF) through July 2024 (TAF version 7.1). The table includes states that use HealthCare.gov.
Notes:

1. This table includes Marketplace consumers who submitted a HealthCare.gov application from March 6, 2023 - October 6, 2024 or who had an inbound account transfer from April 3, 2023 - November 7, 2024, who can be linked to an enrollment record in TAF that shows a last day of Medicaid or CHIP enrollment from March 31, 2023 - July 31, 2024. Beneficiaries with a leaving event may have continuous coverage through another coverage source, including Medicaid or CHIP coverage in another state. However, a beneficiary that lost Medicaid or CHIP coverage and regained coverage in the same state must have a gap of at least 31 days or a full calendar month.
2. This table includes Medicaid or CHIP beneficiaries with full benefits in the month they left Medicaid or CHIP coverage.
3. ‘Account Transfer Consumers Whose Medicaid or CHIP Coverage was Terminated’ are consumers 1) whose full benefit Medicaid or CHIP coverage was terminated and 2) were sent by a state Medicaid or CHIP agency via secure electronic file to the HealthCare.gov Marketplace in a process referred to as an inbound account transfer either 2 months before or 4 months after they left Medicaid or CHIP. 'Marketplace Consumers Not on Account Transfer Whose Medicaid or CHIP Coverage was Terminated' are consumers 1) who applied at the HealthCare.gov Marketplace and 2) were not sent by a state Medicaid or CHIP agency via an inbound account transfer either 2 months before or 4 months after they left Medicaid or CHIP.
4. Marketplace consumers counts are based on the month Medicaid or CHIP coverage was terminated for a beneficiary. Counts include all recent Marketplace activity.
5. HealthCare.gov data are organized by week. Reporting months start on the first Monday of the month and end on the first Sunday of the next month when the last day of the reporting month is not a Sunday. HealthCare.gov data are through Sunday, October 6.
6. Data are preliminary and will be restated over time to reflect consumers most recent HealthCare.gov status. Data may change as states resubmit T-MSIS data or data quality issues are identified.
7. See the data and methodology documentation for a full description of the data sources, measure definitions, and general data limitations.

Data notes:

1. The percentages for the 'Marketplace Consumers Not on Account Transfer whose Medicaid or CHIP Coverage was Terminated' data record group are marked as not available (NA) because the full population of consumers without an account transfer was not available for this report.
2. Virginia operated a Federally Facilitated Exchange (FFE) on the HealthCare.gov platform during 2023. In 2024, the state started operating a State Based Marketplace (SBM) platform. This table only includes data about 2023 applications and policies obtained through the HealthCare.gov Marketplace. Due to limited Marketplace activity on the HealthCare.gov platform in November 2023, data from November 2023 onward are excluded. The cumulative count and percentage for Virginia and the HealthCare.gov total reflect Virginia data from April 2023 through October 2023.

APTC: Advance Premium Tax Credit; CHIP: Children's Health Insurance Program; QHP: Qualified Health Plan; NA: Not Available

description:

A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified health plans (QHPs) offered on HealthCare.gov. Plan information incudes details about essential health benefits, cost sharing, rates, and geographic coverage.

; abstract:

A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified health plans (QHPs) offered on HealthCare.gov. Plan information incudes details about essential health benefits, cost sharing, rates, and geographic coverage.

This dataset tracks the updates made on the dataset "HealthCare.gov Marketplace Medicaid Unwinding Report" as a repository for previous versions of the data and metadata.

Every state will have a Health Insurance Marketplace, but each state can choose how it will operate. States can create and run their own Marketplace, or have a Marketplace supported by the Department of Health and Human Services (HHS). States may also choose to partner with HHS to run some functions of their Marketplace.

HHS already has granted conditional approval to some states. This means they are on track to have a Marketplace starting in October 2013.

The links below take you to websites that describe that states Marketplace efforts. The Marketplaces themselves will not begin accepting enrollments until October 2013.

This table includes Marketplace consumers who submitted a HealthCare.gov application from March 6, 2023 - October 6, 2024 or who had an inbound account transfer from April 3, 2023 - November 7, 2024, who can be linked to an enrollment record in TAF that shows a last day of Medicaid or CHIP enrollment from March 31, 2023 - July 31, 2024. Beneficiaries with a leaving event may have continuous coverage through another coverage source, including Medicaid or CHIP coverage in another state. However, a beneficiary that lost Medicaid or CHIP coverage and regained coverage in the same state must have a gap of at least 31 days or a full calendar month.

This dataset tracks the updates made on the dataset "#DDOD Use Case: Accuracy of healthcare.gov Plan Finder" as a repository for previous versions of the data and metadata.

In 2023, nearly ********* of all received in-network claims were denied by HealthCare.gov issuers in the United States. This was the highest denial rate for in-network claims in the given period since 2015.

This statistic displays the contractors hired for Obamacare's HealthCare.gov website which was launched in October 2013 and the value of their contracts in million U.S. dollars. During this year, the contract for IDL Solutions was worth 31.8 million U.S. dollars. HealthCare.gov has cost about 800 million U.S. dollars and includes 60 contracts with 33 different companies. The lack of coordination between the contractors has lead to wavering in HealthCare.gov in 2013.

Access Data Dictionary Here - Data Dictionary (PDF) Access Lines of Authority Here - NIPR Health Line of Authority

All of the data used on the Finder.HealthCare.gov web application is available through this API. There are multiple collections of data available through the API.
1. Public Options Data - This data set includes Medicaid, CHIP, High Risk and Territory data along with all of the other public options available. The appropriate options are returned based on the criteria submitted in the API call.
2. Individual and Family Health Insurance Options Data - Paginated individual and family health insurance plan data, a subset of the full plan data including pricing, is returned for plans that match the criteria submitted in the API call for available plans. Full plan data is returned when a specific plan is requested with all appropriate criteria.
3. Small Group Insurance Options Data - Paginated Small Group health insurance product data, a subset of the full product data including pricing, is returned for products that match the criteria submitted in the API call for available products. Full product data is returned when a specific product is requested with all appropriate criteria.

This dataset provides sample premium information for individual ACA-compliant health insurance plans available to Iowans for 2025 within Silver, Bronze and Gold metal levels for each county. The premiums provided in the dataset for each plan are for informational purposes only.

Plan choices under the Affordable Care Act fall into different categories or metal levels, i.e., bronze (60%), silver (70%), gold (80%), platinum (90%), and catastrophic (less than 60% -- generally limited to those under the age of 30). A silver plan (on average) would be expected to pay around 70% of healthcare expenses for a standard population. The individual, therefore, would pay about 30%. This dataset does not include platinum or catastrophic.

On or after November 1, 2024, please go to www.healthcare.gov to view available plans.

The dataset holding the information for the issuer-partner-lookup tool.

https://data.healthcare.gov/issuer-partner-lookup

The Network PUF (Ntwrk-PUF) is one of the seven files that make up the Marketplace PUF. The Ntwrk-PUF contains issuer-level data identifying provider network URLs. These data either originate from the Network ID template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).

ECP Rolling Draft Dataset. Please visit https://data.healthcare.gov/rolling-draft-list to search and filter for your provider site within the Rolling Draft Essential Community Provider (ECP) List.

This explorer provides sample premium information for individual ACA-compliant health insurance plans available to Iowans for 2025 based on age, rating area and metal level. These are premiums for individuals, not families. Please note that not every plan ID is available in every county. On or after November 1, 2024, please go to www.healthcare.gov to determine if your plan is available in the county you reside in.

Access Data Dictionary Here - Data Dictionary (PDF)

The Service Area PUF (SA-PUF) is one of the seven files that make up the Marketplace PUF. The SA-PUF contains issuer-level data on the geographic coverage or service area (i.e., where the plan is offered) including state, county, and zip code. These data either originate from the Service Area template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).

The Presidents Information Technology Advisory Committee PITAC is appointed by the President to provide independent expert advice on maintaining Americas preeminence in advanced information technology IT. PITAC members are IT leaders in industry and academia with expertise relevant to critical elements of the national information infrastructure such as high-performance computing, large-scale networking, and high-assurance software and systems design. The Committees studies help guide the Administrations efforts to accelerate the development and adoption of information technologies vital for American prosperity in the 21st century.

The HCUP Summary Trend Tables include monthly information on hospital utilization derived from the HCUP State Inpatient Databases (SID) and HCUP State Emergency Department Databases (SEDD). Information on emergency department (ED) utilization is dependent on availability of HCUP data; not all HCUP Partners participate in the SEDD. The HCUP Summary Trend Tables include downloadable Microsoft® Excel tables with information on the following topics: Overview of monthly trends in inpatient and emergency department utilization All inpatient encounter types Inpatient stays by priority conditions -COVID-19 -Influenza -Other acute or viral respiratory infection Inpatient encounter type -Normal newborns -Deliveries -Non-elective inpatient stays, admitted through the ED -Non-elective inpatient stays, not admitted through the ED -Elective inpatient stays Inpatient service line -Maternal and neonatal conditions -Mental health and substance use disorders -Injuries -Surgeries -Other medical conditions Emergency department treat-and-release visits Emergency department treat-and-release visits by priority conditions -COVID-19 -Influenza -Other acute or viral respiratory infection Description of the data source, methodology, and clinical criteria