- Uninsured Rates Lower in States That Run Their Own ACA Exchanges Modern Healthcare by Shelby Livingston — The average uninsured rate in states that use the federal HealthCare.gov exchange is nearly double that of states that set up their own public health insurance exchanges, data released by the Centers for Disease Control and Prevention show. In the first six months of 2017, HealthCare.gov states had an average uninsured rate of 16.1 percent, while states with their own exchanges — like California and Colorado — had an average uninsured rate of 8.3 percent. The disparity in coverage in states that use HealthCare.gov and those with state-based exchanges can be explained, at least in part, by Medicaid expansion.