On Monday Afternoon, the Department of Health and Human Services (HHS) released enrollment numbers for the first three months of operation of the Affordable Care Act’s health insurance exchanges.[1] Despite strong December enrollment, total enrollment is still only 65 percent of the goal set by HHS for January 1^st.[2] These goals are partly political benchmarks but are also functional targets: each state exchange needs enough members to absorb high costs. And because each state has a separate risk pool, it is important to examine state enrollment trends independently. Through the end of December, only 10 states have succeeded in meeting or surpassing their enrollment goals, as shown in the chart below. In contrast, none of the 10 worst performing states have enrolled more than 40 percent of their enrollment goals for the first three months of enrollment.