Medicaid and CHIP Marketplace Interactions

This table highlights some of the critical intersections between the Marketplace, Medicaid, and CHIP. The table lists the Marketplace model each state has selected for 2015 — State-based, Federally-facilitated, or working in partnership with the Federal Marketplace — and indicates whether states with a Federally-facilitated Marketplace (FFM) have elected to have the FFM make assessments of Medicaid/CHIP eligibility, transferring the account to the Medicaid/CHIP agency for a final determination, or whether the state has delegated the authority to make Medicaid/CHIP eligibility determinations to the FFM.

State Medicaid/CHIP and Marketplace Interactions (As of November 1, 2015)
State Marketplace Model: SBM/Partnership/FFM FFM Assessment vs. Determination
Alabama FFM Determination state
Alaska FFM Determination state
Arizona FFM Assessment state
Arkansas FFM Partnership Model Determination state
California SBM  
Colorado SBM  
Connecticut SBM  
Delaware FFM Partnership Model Assessment state
District of Columbia SBM  
Florida FFM Assessment state
Georgia FFM Assessment state
Hawaii SBM Assessment state
Idaho SBM  
Illinois FFM Partnership Model Assessment state
Indiana FFM Assessment state
Iowa FFM Partnership Model Assessment state
Kansas FFM Assessment state
Kentucky SBM Assessment state 
Louisiana FFM Determination state
Maine FFM Assessment state
Maryland SBM  
Massachusetts SBM  
Michigan FFM Partnership Model Assessment state
Minnesota SBM  
Mississippi FFM Assessment state
Missouri FFM Assessment state
Montana FFM Determination state
Nebraska FFM Assessment state
Nevada SBM** Assessment state
New Hampshire FFM Partnership Model Assessment state
New Jersey FFM Determination state*
New Mexico SBM** Assessment state
New York SBM  
North Carolina FFM Assessment state
North Dakota FFM Assessment state
Ohio FFM Assessment state
Oklahoma FFM Assessment state
Oregon SBM** Assessment state
Pennsylvania FFM Assessment state
Rhode Island SBM  
South Carolina FFM Assessment state
South Dakota FFM Assessment state
Tennessee FFM Determination state*
Texas FFM Assessment state
Utah FFM Assessment state
Vermont SBM  
Virginia FFM Assessment state
Washington SBM  
West Virginia FFM Partnership Model Determination state
Wisconsin FFM Assessment state
Wyoming FFM Determination state***

* The state Medicaid agency has delegated authority to the Marketplace to make determinations of eligibility for Medicaid and CHIP as a mitigation strategy.


** For Plan Year 2015, the state’s Marketplace will be using the FFM’s information technology platform for eligibility and enrollment functions.  Therefore, the FFM will also be making either assessments or determinations of Medicaid and CHIP eligibility. It is important to note that even though the state is relying on the FFM for this functionality, the state may still be operating its own SHOP marketplace in Plan Year 2015.


***The state has delegated authority to the Marketplace to make determinations of eligibility for Medicaid; the Marketplace makes only an assessment of CHIP eligibility.