Healthcare.gov was seen as a disaster. Some states, however, opted to create their own exchange. California, for instance, created the “Covered California” website and exchange. How many states decided to create their own exchange? A Robert Wood Johnson issue brief notes that:
[Sixteen] States (and DC) established their own marketplaces; 27 states chose, or defaulted to, a federally-run marketplace. Because of time constraints, two of the state-based marketplaces (New Mexico and Idaho) are using the federal IT platform while they develop their own.
In which States did the exchanges lead to the largest update in insurance?
The enrollment rate varies from state to state, with a high of 54% in Vermont to a low of 5% in Massachusetts. We should note that Massachusetts had the lowest rate of uninsurance in the nation since its health reform in 2006; its previous success might mean that the remaining uninsured population could be especially difficult to reach…
On average, state-based marketplaces have had higher enrollment rates (20.3% of eligibles) than the federally facilitated ones (12.4%) or the partnership states (13.9%).
Note, however, that these figures represent the share of individuals who were uninsured or who had previously had an individual plan (i.e., not Medicare, Medicaid, or an employer-provided group plan), and thus these estimates somewhat overstate the impact of ACA on uninsurance rates.