By Jodie Tillman published in the Tampa Bay Times on May 2, 2014

Nearly a million Floridians signed up for health care plans sold through the Affordable Care Act marketplace, the most of any state that used the federal marketplace rather than create one of its own.

But the final enrollment counts, released Thursday by the Obama administration, can't yet answer the question of how the law is affecting Florida's high rate of residents who have no health insurance. Administration officials acknowledged they don't yet know how many of those who signed up for plans were merely switching from other insurance and how many previously had no coverage. 

Still, officials said they were pleased that the final tally exceeded expectations, despite the many challenges people faced navigating the marketplace, including a government web site that didn't function when it rolled out. "Together we are ensuring that health coverage is more accessible than ever before," said Health and Human Services Secretary Kathleen Sebelius.

Overall, more than 8 million Americans picked a plan through government exchanges, more than the 7 million that had been expected. Just under 30 percent of enrollees are ages 18 to 34, a group insurers covet since they generally have fewer health expenses than older people. 

Insurers, who can no longer discriminate against people with pre-existing health conditions, are counting on a good mix of customers to keep their plans affordable.

Some studies consider 40 percent in the young adult age group optimal to stabilize the market. Still, 30 percent is a higher share than the exchanges initially saw. 

The young adult population makes up about 27 percent of Florida's signups, an improvement from January's 20 percent. Many experts had expected young adults to wait toward the end of the enrollment period before signing up.

The new report also released for the first time a breakdown of consumers by race. In Florida, about 20 percent of people who purchased plans are Latino and another 20 percent are black. Whites made up the majority of the people who chose a plan, about 54 percent. 

Overall, Florida's enrollment more than doubled over the month of March, the third biggest jump in the nation.

The Congressional Budget Office estimates another 5 million people nationwide bought individual coverage directly from private insurers. Those consumers don't get tax subsidies since they didn't go through government exchanges, but the policies they buy meet the new federal coverage requirements. 

The 2014 private insurance market is now closed for business except for consumers who qualify for a special enrollment period, such as those who have lost a job or had a baby. Plans for next year go on sale this fall.

Nearly 3.8 million people in Florida lacked health insurance as of last year. 

An estimated 800,000 will remain uninsured due to the Florida Legislature's decision to reject $51-billion in federal funding to expand Medicaid eligibility, a key part of the Affordable Care Act. Because of the way the law is written, those Floridians fall into a coverage gap: They can't qualify for Medicaid but they're too poor to qualify for tax subsidies to buy coverage.

Florida's political climate is widely seen as hostile to the Affordable Care Act, yet consumers still enrolled. Obama administration officials credited an outreach campaign that included local organizations and popular enrollment fairs. 

That work "really helped to make a difference in that state," said Julie Bataille, spokeswoman for Centers for Medicare & Medicaid Services.

U.S. Rep. Kathy Castor, D-Tampa, released a statement touting Florida's enrollment figure, officially 983,775. 

"One million Floridians are breathing easier as affordable health insurance that was previously out of reach now provides financial security. Despite political obstruction and scare tactics, Florida and Tampa Bay navigators and health care outreach partners successfully aided scores of our neighbors," said Castor.