According to data released last week by the Department of Health and Human Services (HHS), more than 106,000 Americans (just 20 percent of the anticipated enrollment) selected plans during the new health insurance marketplace’s first reporting period of open enrollment. Only a small percentage of enrollees came from states relying on the federal exchange – states with the highest numbers of uninsured residents.

Due to technical problems with the federally run exchange website, only around a quarter of shoppers purchased plans there, according to the HHS report. The majority of packages were purchased through state-based marketplaces in places like Vermont and Connecticut. The Pew Research Center suggests this could be a problem, as states with the highest percentages of uninsured residents have refused to set up exchanges, and many, like Florida and Texas, have actively opposed the health care law.

16 states and the District of Columbia have set up state-run exchanges. Seven more are partnering with the federal government to run an exchange. Pew reports this leaves the residents of 27 states using the federally managed exchange to shop for coverage.  See image below for a complete breakdown:

(Image courtesy of the Pew Research Center)

Residents of those 27 states, which include large portions of the south and Midwest, contain a majority of the nation’s uninsured population - 59.4 percent, to be exact. Collectively, 16.8 percent of people without access to state-run exchanges were without insurance last year, compared to 14 percent in states with organized exchanges, according to Pew.

Using data compiled by the Census Bureau, USA Today reported the top five states with the highest percentages of uninsured individuals. Only one of these states, Nevada, runs its own exchange, and all saw low registration numbers, according to HHS figures. They are:

  • Georgia: 18.4 percent uninsured, 1,390 registrants
  • Florida: 20.1 percent uninsured, 3,571 registrants 

  • Alaska: 20.5 percent uninsured, 53 registrants
  • Nevada: 22.2 percent uninsured, 1,217 registrants
  • Texas: 22.5 percent uninsured, 2,991 registrants

Nationally speaking, "To date, 106,185 persons have selected a Marketplace plan — this includes 79,391 in [state-based marketplaces] and 26,794 in [federally facilitated marketplaces]," according to the HSS report. "An additional 975,407 persons who have been determined eligible have not yet selected a plan through the Marketplace,” National Public Radio reports.

Four important numbers were highlighted in the HHS report, according to NPR:

  • 846,184 applications have been completed
  • 1,509,883 people are included in those completed applications
  • 396,261 individuals have deemed eligible for Medicaid or the Children’s Health Insurance Program, and
  • 106,185 people have selected insurance plans for 2014.

These numbers are only around 20 percent of what they were expected to be for October, but HHS is optimistic turnout will improve as glitches with the federal site are resolved.

"The promise of quality, affordable coverage is increasingly becoming reality for this first wave of applicants to the Health Insurance Marketplaces," HHS Secretary Kathleen Sebelius said in a statement. "We expect enrollment will grow substantially throughout the next five months.”