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5 States With the Most Abominable Obamacare Enrollment Numbers

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Yet another batch of numbers have been released for enrollment on the marketplaces established as part of the Affordable Care Act, commonly known as Obamacare. Around 3.3 million Americans have now signed up. That's worse than the 4.4 million projected for the end of January by Centers for Medicare and Medicaid Services, or CMS. However, it's better than many expected after the disastrous launch of the online exchanges.

Digging into the data reveals that some states lag well behind others. Which states have the most abominable Obamacare enrollment numbers of all? It depends on your perspective. Here are two ways of ranking the worst-performing states.

By percentage of potential market size
We could simply look at the states with the lowest enrollment totals. However, this approach would tend to put states with smaller populations at the bottom. A better method is to determine which states have the lowest enrollment as a percentage of potential market size. Using this option, here are the worst states for Obamacare enrollment.

Sources: U.S. Department of Health and Human Services, Kaiser Family Foundation 

Massachusetts comes in at the bottom of the list. However, it's important to note that the state already implemented a health insurance program several years ago that is similar in many respects to Obamacare. A lower enrollment figure for Massachusetts, therefore, shouldn't be a surprise.

All of the other four states performing the worst in terms of enrollment as a percentage of potential market size rely on the federally operated website. South Dakota reported only 5,077 individuals signing up for health insurance -- 4.3% of the state's potential market size as estimated by the Kaiser Family Foundation. Iowa wasn't far behind with a 4.5% figure, representing 11,788 enrollees.

North Dakota and Oklahoma rounded out the bottom five using this method. Both states reported enrollment as a percentage of potential market size less than half of the national average.

By percentage of younger enrollees
Looking at low enrollment might not be the best way to determine which states have the most abominable numbers, though. Ranking states by the percentage of young, presumably healthier individuals is probably a better approach. If too few younger residents sign up for Obamacare, insurers could incur losses.

Source: U.S. Department of Health and Human Services 

West Virgina, Arizona, and Maine stand out as the three worst states in terms of enrollment of younger individuals desired by health insurers. There is a six-way tie for fourth-place. New Mexico, Hawaii, Ohio, Delaware, Wisconsin, and Vermont all reported only 20% of total enrollment from residents between the ages of 18 and 34. Fifth-place also ended in a two-way tie between Arkansas and Minnesota.

If we use actual enrollment numbers of younger residents to break the tie, the worst-performing "honors" go to Hawaii and Delaware. The Aloha State only reported 723 younger residents signing up for health insurance. Delaware wasn't much higher, with 985 residents between the ages of 18 and 34 enrolling.

How abominable is abominable?
Actually, the numbers reported by the states are worse than the actual enrollment figures. That's because the Health and Human Services totals include individuals who haven't paid their first month premiums. These non-payers won't really be enrolled by health insurance companies. The problem is: We don't know how many haven't paid yet.

Aetna (NYSE: AET  ) , however, said recently that over 70% of individuals signing up for insurance through the Obamacare exchanges have paid their first premium. The large insurer isn't participating in any of the states ranking at the bottom in terms of enrollment as a percentage of potential market size.

Even though total Obamacare enrollment might be well behind projections, it's not a big problem for everyone. WellPoint (NYSE: ANTM  ) announced that enrollment in its Obamacare health plans is ahead of expectations. CEO Joe Swedish said that the company is "encouraged" by its results so far. 

However, even surpassing expectations might not be good enough for WellPoint. Analyst A.J. Rice of UBS estimates that the company could report a net loss of $236 million in 2014 due to its participation in Obamacare exchanges. While WellPoint will gain some individual customers from the Obamacare signups, Rice doesn't think that will be enough to offset the number of customers the company will lose because of health reform. 

What about those low numbers of young Americans enrolling? That could be a bigger issue, but research by the Kaiser Family Foundation suggests the problems won't be too damaging. According to Kaiser, even if enrollment of younger Americans is 25% of total enrollment, "overall costs in individual market plans would be about 2.4% higher than premium revenues." 

So while the states discussed above do have the worst Obamacare enrollment numbers, those sub-par results might not matter much in the big scheme of things. Today's abominable figures probably won't seem all that abominable down the road.

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Read/Post Comments (26) | Recommend This Article (8)

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  • Report this Comment On February 16, 2014, at 1:30 PM, Phils456 wrote:

    Why are they all GOP run states? Wonder if there is a connection?

  • Report this Comment On February 16, 2014, at 1:31 PM, PaulSell wrote:

    When asked specifically about the "cooking of the books" on OB☭M☭C☭RE ● enrollment numbers, Kathleen smiled and said, "Pull my finger." When the exact question was also posed to Barry, he tucked in his chin and gave a big toothy smile and said, "I just love that Yahoo picture of me with the Great Seal behind my pointy head, that looks like a halo on me. In addition I just want you all to know, "I have a Bic Pen and an Obamaphone."

    Republicans are now just waiting for Barry & Company to work the kinks out of his legacy legislation OB☭M☭C☭RE●! After all this isn't just more of your Dear Leader's shuck and jive stuff, this is about millions of people's lives. The Republicans have promised to get right on immigration, as soon as

    OB☭M☭C☭RE● smoothes out with the millions of lives it has disrupted. Barry was quoted as saying, "When I go out and say the, "You like it you can keep it's... for years and still just as recently as the SOTU, constantly fudge my numbers and get 4 Pinocchios from the Washington Post the next day for it, I JUST CAN NOT UNDERSTAND WHY "YOU PEOPLE" STILL DON'T BELIEVE MY SHUCK & JIVE SH!T ANYMORE? I know you're all struggling and I want you to just reflect back to Christmas. It only cost you tax paying suckas' $800,000 to bring my main squeeze "Snuff Lip" back from her extended stay in Hawaii. Now, for you millennials: "Welcome to YOUR OB☭M☭C☭RE●! The Liberals, that now have to survive re-election with this albatross hanging around their socialist necks, STILL have to convince you soft headed millennials into another suicide vote for them again. Maybe we, Barry & Company, can just chat up Pot Legalization, minimum wage increase, and Income Inequality, while carefully avoiding your slim to none chances at even getting a job. We Dems are still just going to encourage you boneheads into believing that the lying Dems are actually going to make your lives so much better."

    OB☭M☭C☭RE ● NOW has DEATH SPIRAL written all over it. I do hope the Republicans are meeting with Insurance Companies, as I write, figuring out how to defuse this Economic time bomb, when they regain the Senate in 2014 with their new plan.

  • Report this Comment On February 16, 2014, at 1:47 PM, RFTECH3000 wrote:


    MA is NOT GOP RUN !!!

    In fact MA is as blue as they come !

    But to answer your question , people in Red states don't like obamacare, they are not comfortable with the idea of the government telling them what to do and trying to run their lifes, we work for a living and we know what we want and whats best for us

  • Report this Comment On February 16, 2014, at 2:02 PM, RFTECH3000 wrote:

    the next "milestone" will be May 15th 2014, this is when AETNA will announce their marketplace premiums for 2015 and decide on in which states to offer coverage in 2015 !

    Right now the CEO of AETNA already made a statement that more than likely premiums will see double digit increases and that they also consider pulling out of certain markets , so in other words people who have AETNA now may not be able to keep AETNA in 2015 or pay substantially higher premiums

  • Report this Comment On February 16, 2014, at 2:34 PM, Pete50 wrote:

    I can't blame them, the ACA is NOT real health insurance. To wit:

    The one thing that all of these articles about the ACA omit is the most glaring truth of Obamacare: It is nothing more than catastrophic health care insurance, not health care insurance. There is a difference.

    According to Healthpocket, (as well as other sites about the ACA deductibles and out of pocket expenses of this horrible law), how can anyone who is too poor to afford health care in the first place be capable of paying these?

    In short... the burden to pay is NOT on the the folks who can afford to pay, but on those who DO NOT have the financial mean to pay in the first place. What's wrong with this picture?

    Obamacare is NOT placing the burden of payment on the shoulders of those who can afford health care, but on the very people this ridiculous law is supposed to help... Unless you Obama supporters out there can explain how some one who can't afford more than a Bronze Plan can afford an out of pocket cost of $6,267 to $12,569?

    It's third grade math... if someone does NOT have the income to pay for health insurance in the first place, it's a good bet they can't afford such astronomical, (for them), deductibles. You can not squeeze money out of someone who does not have any.

    Neither Obama, nor his signature train-wreck, is doing anyone ANY favors.

  • Report this Comment On February 16, 2014, at 3:04 PM, bellabijou wrote:

    can't wait to see what happen when people find that buying that 60 inch TV is more desirable than paying for their insurance!!!

  • Report this Comment On February 16, 2014, at 3:44 PM, JMac59 wrote:

    @Phils456, MA is a red state? Really?

    I see you are a typically well informed liberal.

    I live in MA, so let me clue you in. Massachusetts is as blue a state as their is. Our governor is is a Democrats, as is about 90% of our legislature.

    You really should check you rfacts before you come on here and make a fool of yourself.

  • Report this Comment On February 16, 2014, at 5:11 PM, byetore wrote:


    ...I'd say "hopeful" considering how much of a socialist failed abomination Ocommiecare is in the first place.

  • Report this Comment On February 16, 2014, at 6:31 PM, winbills wrote:

    the article pointed out. Mass. was logically lower cause cause they have had obama/romney care for years already........

    people dont need to sign up for health insurance twice...duh

    why dont you try reading the article b-4 you make a fool out of yourself

    and furthermore we do not need health insurance, we need health care

  • Report this Comment On February 16, 2014, at 9:28 PM, i9o0cvfe4r wrote:

    Obama supporters will go hysterical over this well sourced list of 557 examples of his lying, lawbreaking, corruption, cronyism, etc.

  • Report this Comment On February 16, 2014, at 10:05 PM, TimFeatherston wrote:

    Winbills. YOU need to reread it. The chart was for potential participation if they already had it they would not be considered potential . only three percent of the people who did not have insurance signed up for it

  • Report this Comment On February 17, 2014, at 8:41 AM, JePonce wrote:

    mart people that see Obamacare for what it is:

    Baseline legislation for a single payer system.

    A tax

    Control over the survival of the Insurance industry

    Foundation for a new Culture War Brigade demanding the ever-used moral imperative sham

    Access to citizens private records

    and a Death Panel necessary to reduce medical costs, particularly of those over 65 that are no longer meal tickets and require to most medical attention

    All common elements in Marxism... Control

  • Report this Comment On February 17, 2014, at 10:58 AM, sogole wrote:

    People are BROKE!!!!!!

  • Report this Comment On February 17, 2014, at 12:17 PM, DrDick1954 wrote:

    Gotta love it when even MF santions posts by rightwingnutjob trolls, who have absolutely no command of facts or figures. What rubbish. You guys need to grab another beer and go crawl back under your rocks.

  • Report this Comment On February 17, 2014, at 1:32 PM, ScamuelJones wrote:

    These five states have the most intelligent people in the entire USA!

  • Report this Comment On February 17, 2014, at 1:37 PM, Mathman6577 wrote:

    Not sure why the states are being "blamed" for anything connected to the ACA. If I recall correctly it was passed by the Democrat-controlled US Congress and not a single GOP Member voted for it. Ask Nancy Pelosi and Harry Reid about the problems. Oh, they didn't really read it either.

  • Report this Comment On February 17, 2014, at 2:52 PM, Kelly wrote:

    Thank you Massachusetts, South Dakota, Iowa, North Dakota and Oklahoma for leading the fight against obamacare.

    And if you think that Massachusetts is a Republican State, you must live in liberal Bizarroworld.

  • Report this Comment On February 17, 2014, at 4:10 PM, brianpdx wrote:

    When you add the sons and daughters staying on their parents insurance and the Medicaid option your over 10 million people helped by Obamacare.

    Medical costs are nearly flat when before they were escalating far faster than inflation. The 40,000 people dying each year due to a lack of medical insurance now have a chance to live. Insurance companies can't screw the insured as badly as they used to (no lifetime cap, no denial due to preexisting medical problem, etc.).

    Thank you President Obama. Screw you GOP.

  • Report this Comment On February 17, 2014, at 5:07 PM, chiefstokes wrote:

    brianpdx states 40,000 who did not have medical insurance now have a chance to live. What about the 5 million who lost their insurance with most not being able to afford this joke of insurance. I for one is in this group. Why pay for something that I know will not help me. I will pay the penalty. I am an independent that will only pull red levers at elections until this fools law is repealed or replaced.

  • Report this Comment On February 17, 2014, at 6:41 PM, HamSammie wrote:

    Per GDP, americans pay twice as much for healthcare then the french...who have free healthcare. And France rates #1 in healthcare. The US ranks #37, and that's only because of the best cancer centers. Assuming you don't have cancer...your health care ranks around the same as Iran.

    You already pay for health care through the taxes you already pay. Wake up.

  • Report this Comment On February 17, 2014, at 7:28 PM, rose528 wrote:

    just shows how ignorant the nazi fascist party of NO (repugs)followers really are. They think the government will tell them what they can and can not do while the corporate insurance companies tell them what they can and can not do now and charge an arm and a leg to do it

  • Report this Comment On February 17, 2014, at 8:02 PM, Indy123 wrote:

    If it's such a great law.....then why has the mandate been delayed over and over and over.....for every single entity other than the private citizen?? I think Americans have seen through the BS at this point. BO simply has nothing left to hold onto and this bill has his name on it....he will go down with ship if he has to, he actually doesn't care! It's us, the taxpayers, that will pay the price for decades to come. Very sad

  • Report this Comment On February 17, 2014, at 8:03 PM, clutch58 wrote:

    Rose gets fully subsiuized healthcare.

  • Report this Comment On February 17, 2014, at 8:56 PM, davidki3794 wrote:

    The continued comment that the Insurance Companies will lose money is wrong.. according to the ACA the insurance will be covered for any loss they have for the first 3 years (or longer I'll bet) that means that not only will the taxpayers heavily subsidize the folks being insured but the taxpayers will also have to pay out the insurance company loss... No matter how many times it's said Tax Subsidies is paid for by working people earning a decent living and not getting a tax subsidy...

    One of these days folks will figure it out, this is NOT FREE INSURANCE That Obama promised in 2008!

  • Report this Comment On February 18, 2014, at 12:07 PM, JimG wrote:

    Phils456: In North Dakota people are working and not looking for government handouts.

  • Report this Comment On February 21, 2014, at 10:53 AM, JIMFITZSR wrote:















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Keith Speights

Keith began writing for the Fool in 2012 and focuses primarily on healthcare investing topics. His background includes serving in management and consulting for the healthcare technology, health insurance, medical device, and pharmacy benefits management industries.

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