States with the largest ACA enrollment increases | 2025

More than 3 million new enrollees signed up for plans on state and federal ACA marketplaces for 2025. 

As of Jan. 4, 23.6 million people had enrolled in ACA coverage, according to CMS data published Jan. 8, surpassing the record set in 2024. 

Enhanced subsidies have spurred record enrollment in marketplace plans. These subsidies are set to expire at the end of 2025, unless Congress acts to renew them. 

Louisiana saw the highest increase in enrollment of any state, with signups growing by 25.4% from 2024. 

In some states, enrollment declined. In New York, signups fell by 31% compared to January 2024. 

Here are the 10 states that saw the largest increase in ACA enrollments in 2025: 

1. Louisiana: 25.4%
2. Rhode Island: 25%
3. New Jersey: 21.4%
4. West Virginia: 21.3%
5. Massachusetts: 20.4%
6. Michigan: 19%
7. New Mexico: 18.1%
8. Kentucky: 18%
9. Alabama: 17%
10. Iowa: 16.5%