Slightly more than 14,000 Texans enrolled in a health insurance plan through the new insurance exchange during October and November, according to the Department of Health and Human Services (HHS) December Marketplace Enrollment Report. More than 118,000 Lone Star State residents have completed applications and need only select a plan by December 23 to have health insurance effective January 1, 2014. With more than six million Texans lacking health insurance, one million of whom are children, these numbers barely make a dent towards the national goal of universal coverage.

Texas did not build its own health insurance exchange. Residents must access the marketplace through the federal website, and problems with the website during its first two months of operation may, in part, be responsible for the low numbers. However, the state has not been actively promoting the Affordable Care Act exchanges.

Governor Rick Perry is a vocal opponent of the law saying in a November press release, “Obamacare is an abject failure; it’s time to overturn this ill-conceived, job-killing nightmare that ultimately will bankrupt this country.”

While state governments that have embraced Obamacare have been actively encouraging residents to sign up for insurance on the new exchange, the Texas Department of Insurance Health Options page only lists the health insurance marketplace as the final item on a menu of health plan resources.

Texas also declined federal funds offered to states to expand their Medicaid program. More than one million Texans fall in the coverage gap with incomes too high for Medicaid eligibility in the state, but too low to qualify for subsidies under the Affordable Care Act.

The Center on Budget and Policy Priorities estimates that more than two million uninsured adults in Texas would be eligible for Medicaid if the state expanded their Medicaid program. The federal health care marketplace does facilitate Medicaid applications, and an additional 17,000 Texans have been determined eligible in the exchange.

Under the Affordable Care Act, most Americans must have health insurance by April 1, 2014 to avoid a penalty. Consumers that seek insurance effective January 1, 2014 have until December 23 to enroll in a plan. Open enrollment continues through March 31, 2014.

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Gillian Burdett is a freelance writer covering all things home and living. Her work can be found on