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Key Findings:

• In all market areas studied, the issuers participating in Medicaid and CHIP are identical, and the primary care physicians participating in their networks are nearly identical, meaning consumers can make transitions between Medicaid and CHIP without disrupting primary care coverage. Although the programs cover different groups of beneficiaries and are often distinct administratively, issuers seem to treat them as the same program from a network perspective in these market areas.
• Marketplace health maintenance organization (HMO) networks offer consumers substantially less choice in primary care physicians than Marketplace preferred provider organization (PPO) networks and, in three market areas and overall, offer consumers fewer choices than Medicaid and CHIP HMO networks. These findings indicate Marketplace enrollees seeking broader choice in primary care physicians can, in general, attain it by choosing one of the available PPOs.
• All issuers offering plans in the Marketplace, Medicaid, and CHIP use different physician networks for their Marketplace (HMO or PPO) and Medicaid and CHIP plans. This suggests that, within the same issuer, consumers in Marketplace HMO plans will have access to a different network of physicians than consumers in Marketplace PPO plans. Likewise, consumers in these programs will have access to a different network of physicians than those in Medicaid and CHIP plans.
• More than a third of all primary care physicians who partake in the programs we studied participate in at least one Marketplace and one Medicaid and CHIP network. This means patients of these primary care physicians who need to change programs will be able to find at least one network within their new program in which their primary care physician participates. Maintaining the same health insurance issuer at the point of transition is likely to make it easier for consumers to maintain primary care physicians, although it is not a guarantee.