It's been a little longer than two months since Obamacare's health insurance exchanges opened for business, but it's been anything except for smooth sailing for the transformative health law.

According to the Department for Health and Human Services, full enrollment in Obamacare increased by 243% to nearly 365,000 people last month as Medicaid or CHIP eligible people doubled to more than 800,000. Furthermore, some 39 million people have now visited the federally run Healthcare.gov website and another 1.9 million have completed the application process but have yet to select a plan.

By all accounts, these figures are well below the HHS' projections which had targeted 7 million signups by the coverage cutoff date in March and have only further fueled the opposition's call for a repeal of the law.

However, regardless of whether you're a proponent or opponent of Obamacare, it's undeniable that there exists a definitive push toward health reform. Even if the bottom-line Obamacare enrollment figures aren't anywhere near HHS's goal, the nearly 2 million person's who've completed the application process but haven't selected a plan are evidence to the interest by millions of Americans in obtaining affordable health insurance if given the option.

These five states are leading the charge
Despite the downbeat report through two months, five states are soaring above the rest when it comes to signing up currently uninsured persons. As you might expect, the top two states are high population state-run health exchanges, but we're beginning to slowly see states on the federally run Healthcare.gov creep into the picture.

Here are the five states that have given Obamacare the biggest boost so far. 

State

Number of Full Enrollees

California

107,087

New York

45,513

Florida

17,908

Washington

17,770

Texas

14,038

Source: Department of Health and Human Services. (Link opens PDF file.)

Cumulatively, these five states have contributed 202,316 enrollees, or 55.5% of all people who've fully enrolled thus far. In other words, without these states Obamacare would really be in bad shape. In addition, these states also account for 1.52 million of the 3.69 million applicants who have completed their application to file for insurance coverage.

There are what I consider to be two obvious factors worth noting here.

First, states with larger populations are going to draw in a larger number of enrollees in most cases. Oregon, with its paltry 44 signups because of technical issues with its website, is an exception to the rule, but generally speaking, more people equal more signups.

The other factor worth noting here is that states that generally side in favor with Democrats around election time are likely to see better enrollment figures. California, New York, and Washington, for example, are historically Democratic states and were certainly behind President Obama's push to implement this health-reform law. Not surprisingly, many state citizens are happily signing up for health insurance.

Who's benefiting?
The obvious beneficiaries here would be insurers catering to larger state populations. Specifically I'm thinking about a nationwide health insurance provider like WellPoint (NYSE:ANTM), which also caters to Medicaid-based individuals through its purchase last year of Amerigroup for $4.5 billion, and Molina Healthcare (NYSE:MOH), a low-income health insurance provider operating in all the aforementioned states except for New York. Clearly, stronger signups in these five states are going to benefit both companies, as they will benefit from the addition of new members to their network.

Conversely, Aetna (NYSE:AET) just might be kicking itself a bit after pulling out of California and New York's insurance market this past spring and summer. Admittedly, Aetna's business is solid on the commercial side of the business, so it's not as if being absent from California or New York's individual market is a devastating blow to its business. However, in hindsight, I would say that Aetna would probably have been better served sticking in these markets and competing against the incumbent insurance companies.

It remains to be seen how having Healthcare.gov's glitches fixed and the site relaunched is going to affect signups on private insurance platforms, but I would contend that regardless of how Healthcare.gov performs from here on out, the private platform such as Aon (NYSE:AON) and eHealth (NASDAQ:EHTH) will remain winners.

eHealth's private insurance platform operates similarly to Healthcare.gov and allows individuals and employees of small businesses to compare policies and prices with ease. Best yet, they can completely avoid the federally run Healthcare.gov altogether which has become a sticking to point to driving membership gains.

Aon, on the other hand, looks as if it's going to be seeing membership gains really ramp up as corporations look to save money and push away from the traditional practice of covering their employees. Aon, for example, has signed up 18 corporate clients with 5,000 or more employees, and I would anticipate this trend to continue well into next year as companies look to cut costs and Healthcare.gov works on simply fixing all of its individual plan issues.

Fool contributor Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.

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