Health and Human Services officials took a victory lap, noting more than 8 million signed up nationally and spotlighting Florida as one of its highest achievers. But enrollment lagged among Hispanics, who represent the highest uninsured rate of any racial or ethnic group, and the critical 18-to-34-year-old demographic.
In Florida, 106,647 enrollees, or about 19 percent, of the 983,775 who signed up were Hispanic. The figure was only slightly higher for African Americans. The numbers don't reveal a complete picture since applicants were not required to report their race. Just a little more than half of Florida applicants did so.
About 1.1 million, or slightly more than 10 percent of the nation's eligible uninsured Hispanics, live in Florida. Roughly 3.4 million Hispanic Floridians are eligible for coverage in the exchange, behind only California and Texas. The law's benefits are only for citizens and legal US residents.
Hispanics are a relatively young population and many are on the lower rungs of the middle class, in jobs that don't come with health insurance. They've also been key supporters of President Barack Obama in his two presidential campaigns.
But the administration's outreach effort to Hispanics stumbled from the start. The Spanish-language enrollment website, CuidadodeSalud.gov, was delayed for months due to technical problems. Its name sounds like a clunky translation from English: "Care of Health.'' And many criticized the site for mixing Spanish and English to convey information on such basics as insurance copays, which added to confusion.
"The low enrollment among Latinos is an indication of where challenges still lie: the hard-to-reach groups where more outreach is probably needed,'' said Larry Levitt, an expert on health insurance markets at the nonpartisan Kaiser Family Foundation.
The number of "young invincibles'' who enrolled in health plans only jumped slightly in the past two months, from 24 percent to 28 percent. Experts had predicted a surge of last-minute signups in this group. Insurers are counting on the business of young healthy adults to offset the costs of covering older, sicker enrollees. The Obama administration courted them aggressively through social media campaigns and celebrity endorsements.
Florida was among more than a dozen states where enrollment has doubled since March 1, including Texas and Florida. Texas has more uninsured than the Sunshine State but still had only 733,757 to Florida's 983,775, according to the enrollment report.
Florida's success comes despite Republican leaders who fought the Affordable Care Act at every turn, banned navigators from county health departments, offered no state dollars to boost outreach efforts to 3.5 million uninsured, and led the fight to repeal the law.
The swing state benefited from infrastructure created by Democratic-affiliated groups during the past three presidential elections, along with continued investment by the Obama administration and nonprofit advocacy groups. The diverse state will likely be competitive in November's midterm election.
Officials singled out several outreach tactics that boosted Florida's efforts. Repeatedly telling consumers about locations where they could sign up in person and get their questions answered "was something they found tremendously valuable,'' said Julie Bataille, communications director for the Centers for Medicare and Medicaid Services.
A crucial marker of the law's success is still unclear: how many of the people who gained coverage were previously uninsured and how many just shuffled into a different insurance plan. Federal health officials said only 13 percent were previously uninsured, but that the data was unreliable.
Health and Human Services Secretary Kathleen Sebelius has estimated 80 to 90 percent of those who signed up had paid, making their enrollment official. One of the largest insurers, Wellpoint, reported Wednesday that some 90 percent of people signing up for insurance actually had paid.
In addition to those who signed up for the health exchanges, 223,000 Floridians signed up for Medicaid and the children's health program in a state where lawmakers voted against expanding Medicaid to more than 1 million others.