Georgia’s enrollment in the insurance exchange in December reached a level that was almost surprising, given the state’s anemic figure of a month before.

The state had 58,611 sign up by Dec. 28, according to federal statistics released this week, up from 6,859 a month before.

“We’re starting to see real enrollment momentum after such a rocky start,’’ Cindy Zeldin of Georgians for a Healthy Future said Monday, referring to the problem-plagued rollout of the federal exchange website in early fall.

Still, when you compare Georgia’s total to those in similarly sized states that also use the federal exchange, the results are mixed.

Georgia’s enrollment figure exceeded Ohio’s total of 39,955, even though the Buckeye State has a larger total population, ranking 7th in the nation to Georgia’s 8th.

And the Peach State enrollment almost equaled Illinois’ 61,111, even though the latter has the 5th-largest population in the nation. Both those Midwestern states, though, have much lower rates of uninsured residents than Georgia does.

Two states with slightly lower overall populations than Georgia fared better. One, Michigan, enrolled 75,511. And then there’s North Carolina’s whopping 107,778.

Why did the Tar Heel state — which also has a slightly lower uninsured rate than Georgia’s — fare so much better in enrolling residents in the exchange?

“North Carolina got up and running quicker than Georgia did,’’ said Dante McKay, Georgia state director of Enroll America, a national nonprofit encouraging enrollment in the exchanges.

He and others cited the fact that Georgia required navigators and other insurance counselors to obtain separate certification and licensing beyond the federal requirements. That wasn’t the case in North Carolina, McKay said.

Ben Money, CEO of the North Carolina Community Health Center Association, told GHN that many nonprofit groups in North Carolina organized early on in the run-up to the exchange launch. These organizations, he said, “have been meeting and coordinating our efforts.”

Money also cited the pent-up demand for coverage by the uninsured in the state.

The federal data released Monday also shows about 89 percent of North Carolina enrollees qualified for subsidies –- a considerably higher rate than Georgia’s 78 percent, which was very close to the national average.

“This could be a factor as to why a larger share of applicants have chosen plans in North Carolina compared to Georgia,’’ said Tim Sweeney, health policy director for the Georgia Budget and Policy Institute. “Obviously the uptick in enrollment in December is a good sign,’’ he added.

Bill Custer, a health insurance expert at Georgia State University, said Friday that there is a premium differential as well.

Custer said premiums for the second-lowest price Silver plan — the premiums that determine the level of the tax subsidy — in Georgia range from $221 to $446, but in North Carolina, that range is $210 to $259.

So while a majority of Georgians face comparable or lower premiums, Custer said, many Georgians face higher premiums than similar North Carolina residents.

The licensing issue attracted much attention both before and after the exchange launched on Oct. 1.

State Rep. Richard Smith (R-Columbus), chairman of the House Insurance Committee and sponsor of the navigator legislation, said the state wanted to make sure the
navigators met state standards, not just the standards of the federal government.

Georgia Insurance Commissioner Ralph Hudgens, a vocal critic of the Affordable Care Act, told GHN in October that the licensing is necessary to make sure navigators understand programs such as Medicaid and PeachCare in the state, and to run applicants through background checks to make sure felons aren’t hired.

Protesters rallied in November outside the Coweta County Extension Service office to call on the University of Georgia to stop providing navigators to help people comply with the ACA.

The UGA College of Family and Consumer Sciences and Cooperative Extension Service is one of two federal grantees to supply navigators for the state.

And during this legislative session, a bill sponsored by state Rep. Jason Spencer and other Republicans calls for the General Assembly to block state agencies from implementing any provisions of the ACA.

House Bill 707 would prohibit state employees, state agencies, public colleges and universities from enforcing or implementing the health care law.

The proposed Georgia legislation follows a similar effort in South Carolina.

Meanwhile, ACA supporters in Georgia note that there’s much work to do before the initial open enrollment in the exchange ends at the end of March.

“It is important that we continue to get the word out about the new coverage options available to Georgia consumers over the next couple of months,” Zeldin said.