A look at the how states are putting in place President Barack Obama’s health care law, including health insurance exchanges and expansion of Medicaid coverage, along with the number of people in each state who don’t have health insurance:
| STATE | EXCHANGE OPTION | MEDICAID OPTION | UNINSURED RESIDENTS |
|---|---|---|---|
| Alabama | Federal exchange | Not expanding | 696,000 |
| Alaska | Federal exchange | Decision pending | 128,000 |
| Arizona | Federal exchange | Plans expansion | 1,306,000 |
| Arkansas | Federal-state partnership | Decision pending-x | 545,000 |
| California | State exchange | Plans expansion | 7,471,000 |
| Colorado | State exchange | Plans expansion | 817,000 |
| Connecticut | State exchange | Plans expansion | 391,000 |
| Delaware | Federal-state partnership | Plans expansion | 115,000 |
| Washington, D.C. | State exchange | Plans expansion | 65,000 |
| Florida Likely | Federal exchange | Decision pending | 3,952,000 |
| Georgia | Federal exchange | Not expanding | 1,992,000 |
| Hawaii | State exchange | Plans expansion | 102,000 |
| Idaho | State exchange | Decision pending | 239,000 |
| Illinois | Federal-state partnership | Plans expansion | 1,795,000 |
| Indiana | Federal exchange | Decision pending | 856,000 |
| Iowa | Federal-state partnership | Decision pending | 292,000 |
| Kansas | Federal exchange | Decision pending | 361,000 |
| Kentucky | State exchange | Decision pending | 727,000 |
| Louisiana | Federal exchange | Not expanding | 811,000 |
| Maine | Federal exchange | Not expanding | 146,000 |
| Maryland | State exchange | Plans expansion | 734,000 |
| Massachusetts | State exchange | Plans expansion | 215,000 |
| Michigan | Federal-state partnership | Plans expansion | 1,336,000 |
| Minnesota | State exchange | Plans expansion | 453,000 |
| Mississippi | Federal exchange | Not expanding | 530,000 |
| Missouri | Federal exchange | Decision pending-x | 780,000 |
| Montana | Federal exchange | Decision pending-x | 179,000 |
| Nebraska | Federal exchange | Decision pending | 226,000 |
| Nevada | State exchange | Plans expansion | 555,000 |
| New Hampshire | Federal-state partnership | Decision pending | 136,000 |
| New Jersey | Federal exchange | Decision pending | 1,334,000 |
| New Mexico | State exchange | Plans expansion | 506,000 |
| New York | State exchange | Plans expansion | 2,780,000 |
| North Carolina | Federal exchange | Not expanding | 1,583,000 |
| North Dakota | Federal exchange | Decision pending-x | 74,000 |
| Ohio | Federal exchange-xx | Plans expansion | 1,578,000 |
| Oklahoma | Federal exchange | Not expanding | 597,000 |
| Oregon | State exchange | Plans expansion | 678,000 |
| Pennsylvania | Federal exchange | Not expanding | 1,319,000 |
| Rhode Island | State exchange | Plans expansion | 122,000 |
| South Carolina | Federal exchange | Not expanding | 754,000 |
| South Dakota | Federal exchange | Not expanding | 108,000 |
| Tennessee | Federal exchange | Decision pending | 982,000 |
| Texas | Federal exchange | Not expanding | 6,654,000 |
| Utah | Status unclear | Decision pending | 424,000 |
| Vermont | State exchange | Expanding | 61,000 |
| Virginia | Federal exchange-xx | Not expanding | 1,023,000 |
| Washington | State exchange | Expanding | 812,000 |
| West Virginia | Federal-state partnership | Decision pending | 266,000 |
| Wisconsin | Federal exchange | Not expanding | 562,000 |
| Wyoming | Federal exchange | Not expanding | 84,000 |
x-governor supports Medicaid expansion; legislature must approve
xx-state will oversee exchange insurance plans under federal law
Sources: Associated Press Research, U.S. Health and Human Services Department and the Urban Institute.
Copyright 2026 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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