Coordinating Medicaid Eligibility and Enrollment with a Federally Facilitated Marketplace

Assessment vs. Determination Model

State Partnership Marketplaces (SPM) or Federally Facilitated Marketplaces (FFM) are coordinating closely with the federal government on Medicaid eligibility and enrollment. Each state Medicaid agency has chosen whether the Marketplace will only assess, or whether it will also determine Medicaid eligibility for individuals who apply through the Marketplace.

This brief lays out the responsibilities of the SPM and FFM that remain consistent across the assessment and determination models when an individual eligible for Medicaid first goes to the SPM/FFM to apply for health coverage. It explains the differences between the two models and provides short case studies examining the rationales behind a state’s model choice.