Individual Enrollment in Federal and State Health Insurance Marketplaces 2018-2019*

Read a blog about state-based marketplace performance here and view slides comparing state-based and federally-facilitated marketplaces here.

* State-based marketplaces (SBMs) design their enrollment websites, control outreach and marketing, and manage the health plans offered through the marketplace. This data came from publicly available sources or directly from the marketplace. States with federally-facilitated marketplaces (FFM) rely on the federal government to operate all functions of their marketplace, including enrollment websites, outreach, and plan management. In some cases, state departments of insurance have varying levels of outreach or management of health plans offered through the marketplace. SBM-FPs use the federal platform or website but control their outreach and manage the health plans offered through their marketplaces. The enrollment platform (including the website) is controlled by the FFM. Data reported is from the 2018 Marketplace Open Enrollment Period Public Use Files and the 2019 Marketplace Open Enrollment Period Public Use Files.

** The District of Columbia reports that 1,352 lives transitioned from their individual health insurance marketplace to their Small business Health Options Program (SHOP) from 2018 to 2019, a major factor contributing to its individual market loss in 2019.

*** 2019 is the first year that Vermont enacted a policy to permit the sale of individual market plans sold outside its marketplace. This enabled the sale of “mirror” plans that are insulated from premium increases attributed to “silver-loading,” a practice of premium modifications made to account for the loss of federal cost-sharing reduction funding.


View 2017-2018 state-based marketplace enrollment here.