California and Florida lead the way for
state and federal healthcare sign-up markets

As part of the rollout of the Affordable Care Act, states were given the option to build their own health-care exchange, an online marketplace where citizens of that state could purchase health insurance, or have the federal government do it. Later, states were given the freedom under a Supreme Court decision to choose whether to expand Medicaid as the ACA had envisioned. In many cases, states resistant to the health-care law declined to build their own exchanges and declined to expand Medicaid.

Now, more than 8 million people have enrolled in a health plan between Oct. 1 and Mar. 31, including additional special enrollment activity reported through April 19. Comparing this enrollment data with estimates of the number of people who might benefit from a marketplace plan in each state, the sign-up rate tends to be higher in the 14 states operating their own exchanges than in states with the federal exchange.

Between 11% and 20% of market size

Between 20% and 30%

30% and greater

Has a federal exchange

Has a state exchange

Expanded Medicaid

Did not expand Medicaid

Matches your selection

Does not match your selection

See the full interactive

NOTE: Potential enrollee data are provided by the Kaiser Family Foundation. SOURCE: Department of Health and Human Services, Kaiser Family Foundation.