Medicaid & CHIP Marketplace Interactions
This table highlights some of the critical intersections between the Marketplace, Medicaid, and the Children's Health Insurance Program (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||Marketplace Model: SBM/Partnership/FFM||FFM Assessment vs. Determination|
|Arkansas||FFM Partnership Model||Determination state|
|Delaware||FFM Partnership Model||Assessment state|
|District of Columbia||SBM|
|Illinois||FFM Partnership Model||Assessment state|
|Iowa||FFM Partnership Model||Assessment state|
|Michigan||FFM Partnership Model||Assessment state|
|New Hampshire||FFM Partnership Model||Assessment state|
|New Jersey||FFM||Determination state*|
|New Mexico||SBM**||Assessment state|
|North Carolina||FFM||Assessment state|
|North Dakota||FFM||Assessment state|
|South Carolina||FFM||Assessment state|
|South Dakota||FFM||Assessment state|
|West Virginia||FFM Partnership Model||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.