States ranked by ACA enrollment growth in 2024

Open enrollment for the ACA exchanges is finished in most states and a record 21.3 million people are enrolled — a 30% increase year over year, or 5 million people.

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By: Jakob Emerson

Federal premium subsidies drove enrollment growth, along with Medicaid redeterminations.

West Virginia recorded the highest rate of enrollment growth between 2023 and 2024, while Maine and Washington, D.C. reported declining enrollment, according to KFF. The data below reflects enrollment growth as of Jan. 17. Enrollment totals are available here.

States ranked by ACA enrollment growth in 2024:

  1. West Virginia: 80%
  2. Louisiana: 76%
  3. Ohio: 62%
  4. Indiana: 60%
  5. Tennessee: 59%
  6. Mississippi: 56%
  7. Arkansas: 56%
  8. Alabama: 49%
  9. South Carolina: 49%
  10. Georgia: 48%
  11. Arizona: 48%
  12. Texas: 45%
  13. Missouri: 39%
  14. Kansas: 38%
  15. Oklahoma: 37%
  16. Iowa: 35%
  17. New Mexico: 32%
  18. New York: 31%
  19. Florida: 31%
  20. Idaho: 30%
  21. Michigan: 30%
  22. Delaware: 29%
  23. North Carolina: 28%
  24. Massachusetts: 25%
  25. Utah: 24%
  26. Montana: 23%
  27. Wisconsin: 20%
  28. Kentucky: 20%
  29. New Hampshire: 19%
  30. Connecticut: 19%
  31. Washington: 18%
  32. Colorado: 18%
  33. Maryland: 17%
  34. Illinois: 16%
  35. Nebraska: 16%
  36. Vermont: 16%
  37. Virginia: 14%
  38. Minnesota: 14%
  39. Pennsylvania: 13%
  40. North Dakota: 13%
  41. South Dakota: 11%
  42. Rhode Island: 10%
  43. Wyoming: 10%
  44. New Jersey: 8%
  45. Alaska: 7%
  46. Oregon: 2%
  47. Hawaii: 2%
  48. Nevada: 0%
  49. California: 0%
  50. Maine: −3%
  51. District of Columbia: −3%
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