Becker's Healthcare January 16, 2026
New Mexico has seen the biggest increase in ACA enrollment from 2025 to 2026, while North Carolina has seen the largest decrease, according to KFF.
The ranking below uses preliminary CMS data comparing similar periods during the 2025 and 2026 open enrollment periods. The figures do not include final enrollment totals for either year.
The 2026 data includes plan selections through Jan. 3 for federally-facilitated marketplaces and state-based marketplaces using HealthCare.gov, and through Dec. 27 for state-based marketplaces. Idaho is an exception, where open enrollment ran from Oct. 15 through Dec. 15.
The 2025 data includes plan selections through Jan. 4, 2025, for federally-facilitated marketplaces and state-based marketplaces using HealthCare.gov, and through Dec. 28, 2024, for state-based marketplaces.
As of...
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