OBJECTIVES: Due to the introduction of health exchanges in 2014, more than 7 million Americans have gained access to commercial insurance. However, the percentage of potential enrollees covered by exchange-based plans varies widely by state. This study assesses the impact of economic, political, insurance industry and demographic variables on enrollment in plans offered on the exchanges, to identify the key factors likely to influence use of this more-affordable healthcare channel long term. METHODS: Enrollment in state-based exchange plans, participation metrics, costs, and marketplace factors were obtained via census of 148 U.S. health insurers. Demographic information was procured from the U.S. Census Bureau, and state-based political leanings were garnered from 2012 election results. RESULTS: Correlation tests show that no single variable predominantly drove enrollment in exchange-based plans in 2014, but instead reveal a number of influential factors working in unison. Enrollment at the state level correlated most positively with median age, possession of a bachelor’s degree or higher, and 2012 presidential votes secured by President Obama. The average premium for commercial coverage in states prior to the launch of exchanges showed a weaker positive correlation. The strongest negative correlations were average family size and higher uninsured rate at the time of healthcare reform.  Business-related issues, such as the competitive mix in states and participation in exchanges, had limited impact. CONCLUSIONS: Enrollment in exchange-based healthcare plans in 2014 was driven by a number of factors, none of which predominated. Data suggest that enrollment in exchanges outperformed in states comprising older, better-educated, and more liberal Americans, a group likely already predisposed to favor healthcare reform. Conversely, enrollment was lower in states housing larger families, and more uninsured citizens to start with. Overall, demographic rather than economic issues directly look set to drive participation in exchange-based health insurance in future years.