CAPITOL FACTS & FIGURES

THE COUNCIL OF STATE GOVERNMENTS

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ACA Open Enrollment Closes with 8 Million Getting Insurance:
Another 4 Million Enroll in Expanded Medicaid
After a rocky rollout, health insurance exchanges across the
country fnished the open enrollment period with 8,019,763
individuals selecting health policies available through the
exchanges.
1

In the District of Columbia and the 14 states operating their
own exchanges, 2.6 million selected plans, 32 percent of the
total new plans.
The numbers of individuals selecting plans through the
state-run exchanges ranged from 1.4 million in California
to 8,592 in Hawaii. President Obama and others cited states
like Connecticut and Kentucky for their success.
The majority of states36elected to use the federal
exchange to implement the health insurance portions of the
Affordable Care Act. In these states, 5.4 million individuals
selected plans.
The largest number of plans selected from the federal
exchange was in Florida, where nearly 1 million people
accessed health insurance plans, and in Texas, where 730,000
selected plans.
Data released by the U.S. Department of Health and Human
Services suggest afordability has been a barrier to health
insurance for many.
HHS reported 85 percent of those selecting a health
insurance plan through the exchanges qualied for some
subsidy to reduce the premium cost.
2

Subsidies under the Affordable Care Act are avail-
able for individuals with incomes between 100 and 400
percent of the federal poverty level. In 2014, the federal
poverty level for a family of four is $23,850.
3

Exchanges also determined that 6.7 million individu-
als who made application were eligible for Medicaid or
CHIP, public health insurance for children from low-
income families.
The Afordable Care Act was designed to provide expanded
Medicaid eligibility to individuals with incomes below 138 per-
cent of the federal poverty level, but in its decision upholding
the health reform law, the U.S. Supreme Court put the eligibil-
ity expansion decision in the hands of each individual state. To
date, 26 states have authorized expanded eligibility.
HHS data compared Medicaid enrollment in states from July-
September 2013 to March 2014. Enrollment in the program
grew by 4,356,679 people.
In the 26 expansion states, the total additional enrollment for
the study period is 4.1 million, 94 percent of new Medicaid
enrollees.
For three of the 26 statesConnecticut, Delaware and North
DakotaMedicaid enrollment data were unavailable.
In Wisconsin, Medicaid enrollment fell by 10,651 during the
October 2013 through March 2014 period. Wisconsin had
already expanded eligibility toand beyond138 percent
of the federal poverty level before the passage of the Afford-
able Care Act.
Individuals can continue to enroll in Medicaid at any time.
There is no open enrollment period.
4

HEALTH
REFERENCES
1
U.S. Department of Health and Human Services, Ofce of the Assistant Secretary for Planning and Evaluation,
Health Insurance Marketplace: Summary Enrollment Report for the initial Annual Open Enrollment Period, For
the period: October 1, 2013 March 31, 2014,http://aspe.hhs.gov.
2
Ibid.
Debra Miller, Director of Health Policy | dmiller@csg.org
3
U.S. Department of Health and Human Services, Ofce of the Assistant Secretary for Planning and Evaluation,
2014 Poverty Guidelines, http://aspe.hhs.gov/poverty/14poverty.cfm.
4
U.S. Department of Health and Human Services, Ofce of the Assistant Secretary for Planning and Evaluation,
Profles of Afordable Care Act Coverage Expansion Enrollment and Medicaid/CHIP and the Health Insurance
Marketplace, 10-1-2013 TO 3-31-2014,http://aspe.hhs.gov.
State Exchange Type*
Total Applicants
Eligible to
Enroll in an
Exchange Plan
Eligible
Applicants
to Enroll in
Exchange Plan
with Financial
Assistance
Number of
Individuals Who
Have Selected an
Exchange Plan
Medicaid Eligibil-
ity Expansion (as
of May 2014)
Determined
Eligible for
Medicaid/CHIP
by the Exchange
Change in
Medicaid/CHIP
Enrollment
March 31, 2014
and pre-ACA
Monthly Average
Enrollment (July-
Sept. 2013)
Alabama Federally run 195,779 105,059 97,870 22,564 -24,883
Alaska Federally run 21,915 14,898 12,890 4,172 -1,179
Arizona Federally run 216,951 144,376 120,071 Expansion 101,282 99,240
Arkansas Federally run 80,709 53,958 43,446 Expansion 73,681 124,865
California State 1,886,867 1,458,433 1,405,102 Expansion 1,700,000 1,177,000
Colorado State 205,910 88,208 125,402 Expansion 181,983 229,524
Connecticut State 113,390 80,354 79,192 Expansion 138,908 N.A.
Delaware Federally run 24,721 16,170 14,087 Expansion 11,200 N.A.
District of Columbia State 15,437 4,033 10,714 Expansion 19,464 5,457
Florida Federally run 1,603,575 1,114,877 983,775 180,479 223,056
Georgia Federally run 572,025 343,925 316,543 91,914 98,834
Hawaii State 15,694 4549 8,592 Expansion N/A 32,209
Idaho Federal Support 107,849 83,662 76,061 10,709 19,017
Illinois Federally run 369,696 242,255 217,492 Expansion 181,070 38,510
Indiana Federally run 229,815 155,961 132,423 94,495 45,044
Iowa Federally run 57,184 37,328 29,163 Expansion 36,891 78,860
Kansas Federally run 99,380 59,601 57,013 13,961 22,498
Kentucky State 201,593 91,092 82,747 Expansion 357,990 285,038
Louisiana Federally run 184,041 113,337 101,778 14,359 -7,904
Maine Federally run 68,541 48,531 44,258 7,103 N.A.
Maryland State 99,298 84,015 67,757 Expansion 163,602 236,112
Massachusetts State 31695 N/A 31,695 Expansion N/A 158,710
Michigan Federally run 467,878 297,742 272,539 Expansion 67,217 30,428
Minnesota State 101,645 36,217 48,495 Expansion 144,481 99,643
Mississippi Federally run 117,518 72,219 61,494 13,779 17,821
Missouri Federally run 268,764 166,440 152,335 45,513 -33,832
Montana Federally run 55,675 39,572 36,584 4,638 14,132
Nebraska Federally run 74,606 50,382 42,975 9,879 -9,546
Nevada State 134,942 89,683 45,390 Expansion 182,946 104,659
New Hampshire Federally run 64,901 39,818 40,262 Expansion 7,235 7,617
New Jersey Federally run 301,965 193,286 161,775 Expansion 179,872 98,240
New Mexico Federal Support 58,628 39,543 32,062 Expansion 30,147 60,378
New York State 707,638 369,380 370,451 Expansion 646,018 343,835
North Carolina Federally run 581,173 396,212 357,584 73,898 58,007
North Dakota Federally run 16,627 11,974 10,597 Expansion 6,843 N.A.
Ohio Federally run 285,967 185,780 154,668 Expansion 156,899 208,280
Oklahoma Federally run 127,915 76,301 69,221 17,374 38,278
Oregon State 124,840 99,902 68,308 Expansion 207,329 273,681
Pennsylvania Federally run 549,205 332,915 318,077 42,335 40,988
Rhode Island State 43,295 32,471 28,485 Expansion 70,243 53,329
South Carolina Federally run 213,974 134,969 118,324 28,359 53,644
South Dakota Federally run 24,147 16,243 13,104 3,850 210
Tennessee Federally run 305,628 169,470 151,352 83,591 53,665
Texas Federally run 1,371,157 835,519 733,757 141,494 3,214
Utah Federally run 130,945 97,621 84,601 50,268 10,384
Vermont State 95,203 28,797 38,048 Expansion 41,704 46,447
Virginia Federally run 392,340 231,534 216,356 48,660 36,556
Washington State 240,880 151,441 163,207 Expansion 909,752 252,249
West Virginia Federally run 36,749 24,634 19,856 Expansion 21,019 136,418
Wisconsin Federally run 230,516 168,721 139,815 Expansion 81,274 -10,651
Wyoming Federally run 20,806 14,629 11,970 2,216 -4,038
TOTAL, All States 13,547,592 8,748,037 8,019,763 26 & D.C. 6,724,660 4,824,044
THE COUNCIL OF STATE GOVERNMENTS
Health exchanges: enrollment as of march/april 2014
Source: Estimated Vaccination Coverage, With Selected Vaccines Among Adolescents Aged 13-17 Years, by State and Selected Area--National Immunization SurveyTeen, United States, 2011. Centers for Disease Control and
Prevention. http://www.cdc.gov/vaccines/stats-surv/nisteen/tables/11/tab01_iap_2011.pdf.
Data Sources: Heath Insurance Marketplace: Summary Enrollment Report for the initial Annual Open Enrollment Period, For the period: October 1, 2013-March 31, 2014, U.S. Department of Health and Human Services, Ofce of the Assistant Secretary for Planning
and Evaluation, http://aspe.hhs.gov and Profles of Afordable Care Act Coverage Expansion Enrollment and Medicaid/CHIP and the Health Insurance Marketplace, 10-1-2013 to 3-31-2014, U.S. Department of Health and Human Services, Ofce of the Assistant
Secretary for Planning and Evaluation, http://aspe.hhs.gov.
*14 states and D.C. opted to run their own health insurance exchanges during the 2014 open enrollment period. Two states (Idaho and New Mexico) operated an exchange in partnership with the federal government, taking on some functions themselves. In the
remainder of the states (34), the exchanges were federally run.