Recently, the Department of Health and Human Services (HHS) released total Health Insurance Marketplace enrollment by zip code for states using the federal exchange.[1] The State Health Access Data Assistance Center (SHADAC) compiled the data nicely into an interactive map. However, the SHADAC map does not provide insight into how well the Affordable Care Act enrolled the target population, and where there remain significant numbers of unenrolled but eligible individuals. The American Action Forum estimated potentially eligible enrollees using county-level 2010 – 2012 American Community Survey data. The map below shows the percent of eligible enrollees that had selected a plan in the Marketplace by the end of open enrollment.[2]

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[1] Plan Selections by ZIP code in the Health Insurance Marketplace, Office of The Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, September 2014, available at: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/EnrollmentByZip/rpt_EnrollmentByZip.cfm

[2] Because of privacy concerns, HHS did not publish the number of plan selections in zip codes where less than 50 individuals enrolled, which accounted for 4 percent of total enrollment. In this analysis, we assume these zip codes had 0 plan selections. Another possible assumption would be to distribute the remaining plan selections evenly across the excluded zip codes, which would slightly raise some enrollment estimates, particularly in rural areas.