So there are no uninsured in states that refused to set up exchanges? Everybody gets to sign up for Medicaid? Sweet!
You and I both live in Rhode Island. You know as well as I do that a (D) in this state is a near guarantee of victory. It is rare that anyone with an (R) after their name would win a statewide election, or any election for that matter, regardless of their actions or results.
RI was one of the first states to set up a healthcare website under the ACA banner, by executive order of the governor (now a (D)).
32 of 38 senate seats and 69 of 75 House seats are Democratic. This a bluer than blue state. They could have stood next to an Obama cutout and still won. We now have a Democratic governor, who, in spite of being despised by the unions for Pension Reform, still managed to win over a Republican who also reformed pensions in his city. Granted, a third party candidate, Healey, may have taken the Republicans votes away, but the result still stands.
Republicans could have turned the entire country red, and Little Rhody would have still been the lone blue light on the map.
Your example means very little in the grand scheme of things across the country.