CMS’ latest Health Insurance Exchange Enrollment fact sheet reports that overall enrollment in the 39 states that use the HealthCare.gov and in the 12 State-Based Exchanges (SBEs) that use their own eligibility and enrollment platforms decreased from 11.8 million in 2018 to 11.4 million in 2019. The proportion of enrollments in the Healthcare.gov states by rural residents remained at its 2018 rate of 18 percent in 2019.