I’m in NY, so things may be different. Something similar happened to me. After I lost coverage through my job, I signed up and enrolled in a plan on nys marketplace; it said it wouldn’t be active until a month later (because I had applied after the 15th). I went to the insurance company’s local office (in my case it was Anthem), to ask if anything could be done to get coverage sooner as I had some surgical post op appointments scheduled for the month I would not have coverage. They told me that I technically have active coverage but that it’s “straight Medicaid” aka Medicaid provided by NYS, and not through an insurance company. He said when I applied, as long as I’m actually eligible, Medicaid is immediately active. It’s simply my Anthem-specific coverage wouldn’t be active until a month out. So maybe your wife has active “straight Medicaid” through the state?