View and compare Affordable Care Act (ACA) Marketplace and Medicaid enrollment in Missouri using data from the Centers for Medicare & Medicaid Services April 2023 and 2025 Open Enrollment Period Public Use Files.
There are several key factors that affected a marked increase in Affordable Care Act (ACA) Marketplace enrollment and decrease in Medicaid enrollment in Missouri between 2023 and 2025:
- End of the formal COVID-19 Public Health Emergency (PHE) and the start of the unwinding, i.e., the gradual rollback, of policies on temporary provisions for continuous coverage of Medicaid enrollees and regulatory flexibilities. With the end of these protections in 2023, Missouri resumed Medicaid eligibility redeterminations, which led to widespread disenrollment as many individuals no longer qualified for Medicaid. Administrative challenges also likely played a role in Medicaid coverage losses.
- Enhanced premium tax credits (EPTCs), which were passed in 2021, and significantly lowered the out of pocket premiums recipients pay for the Marketplace plans.
The dashboards below allow users to view the effects of these events on ACA Marketplace and Medicaid enrollment in Missouri.
The Center for Advancing Health Services, Policy & Economics Research released a related policy brief that provides an analysis of ACA Marketplace and Medicaid enrollment trends by county and rural/urban status in 2023-2025. The policy brief includes recommendations to further analyze and address the enrollment shifts.
