Recently, the Obama administration said 11.3 million Americans had signed up for 2016 health exchange plans by late December.

“That’s still significantly lower than what experts had initially expected at this point in time in exchange implementation,” said Caroline Pearson, senior vice president with health care consulting firm Avalere. “We had anticipated, based on the Congressional Budget Office estimates, that perhaps 21 million people might be enrolled in 2016.”

“Many middle income people continue to suggest that exchange plans just aren’t affordable for them,” Pearson told CNBC. “Even with the subsidies, they simply can’t make the monthly premiums work in addition to all of the out of pocket costs.”