BREAKING: State-based exchanges collectively break all-time enrollment record!

With Covered California releasing their final, official 2019 Open Enrollment Period data, and the latest updates from New York (which still has 2 days to go) and Massachusetts (which wrapped up last week), I now nearly all 2019 OEP data on hand.

I say nearly all because there are still three numbers missing:

• Vermont has yet to release any 2019 enrollment data. This is the 3rd year in a row that they've been radio silent. Assuming they're close to last year (28,763 QHP selections), they should add around 28,000 to the national total.

• New York still has 2 days left for people to #GetCovered. I'm going to assume they'll tack on perhaps 5,000 more people today and tomorrow.

• The District of Columbia hasn't posted any updates since December 11th, which means not only do they still have 2 days for people to sign up, they're actually missing a whopping 51 days worth of enrollment data. Again, assuming they wrap up close to last year, that should mean another 1,400 or so from DC.

Between the three, I'd expect another ~34,000 QHP selections to be tacked onto the totals below.

However, even without that, the 12 state-based exchanges have collectively broken their all-time record for ACA Open Enrollment, racking up more than 3,018,000 QHP selections this season:

Here's what that looks like visually...and the contrast between the Federal Exchange and the State-Based Exchanges is dramatic:

• After a dramatic enrollment increase in 2015 and a lesser increase in 2016, the 39 states hosted by HC.gov have seen a gradual, steady decline each year since. They closed out the 2019 Open Enrollment Period with 1.3 million fewer people having signed up than at their peak in 2016. Perhaps 200,000 or so of this was due to Louisiana and Virginia expanding Medicaid in recent years, but that does nothing to explain the other 1.1 million drop-off, which is almost certainly due to having the HC.gov marketing & outreach budgets being slashed to the bone, the Open Enrollment Period being cut in half and so forth. 

• Meanwhile, the 12 states which operate their own full ACA exchanges (and which have their own marketing/outreach budgets) saw less-dramatic increases in 2015 & 2016...but they've collectively stayed virtual dead even for every year since then. In fact, when the dust settles on the 2019 Period, I expect the 12 state-based exchanges to reach around 3.05 million QHP selections, which would be 1.5% higher than last year and 1.3% higher than their collective all-time high in 2017.