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The ACA MarketplaceS

Change in February effectuated enrollment, by state, 2025-2026

How Has ACA Marketplace Enrollment Changed Across States in 2026?

ACA Marketplace enrollment fell this year in every state except New Mexico, which was the only state to fully replace the enhanced premium tax credits that expired last year with a state-funded subsidy, according to a new KFF analysis of effectuated enrollment data. The Marketplace enrollment decline—the first in seven years—follows several years of rapid enrollment growth and coincides with the end of the enhanced federal subsidies.

How Much and Why ACA Marketplace Premiums Are Going Up in 2027

ACA Marketplaces insurers are proposing a median premium increase of 15% in 2027, according to KFF’s updated analysis of 276 insurers with publicly available filings across all 50 states and the District of Columbia. This is the second consecutive year of double-digit premium hikes. Last year’s median nationwide proposed rate change was 18%, and the median finalized rate change was 20%. While this proposed rate change is lower than last year, it represents the second-highest requested rate change since 2018, as premium growth had been relatively flat in this market for several years.

About the ACA

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Did the Affordable Care Act Make Health Care More Affordable?

The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees. KFF’s Cynthia Cox examines the ACA’s record and the broader underlying question it raises: what’s a fair price for Americans people to pay for health care?

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  • KFF Explores Health Reform and the Tea Party Movement

    Perspective

    With much media discussion of the role that the Tea Party will play in the upcoming congressional midterm elections, the Kaiser Family Foundation took a closer look at Tea Party supporters using its most recent Health Tracking Poll data from September. While 57 percent of voters who do not support the Tea Party movement view the health reform law favorably, 57 percent of Tea Party supporters view the law "very" unfavorably, and another 11 percent…

  • What Issues Are Most Important To Voters in This Election? The Answer Depends On The Question

    Perspective

    Election polling has entered hyperdrive, with several polls released daily. As Nov. 6 draws near, it is important to keep in mind that question wording and format do matter, sometimes quite a lot. In our October Kaiser Health Tracking Poll, we measured voters’ top issue priorities two ways: First, we asked one group to name the most important issue to their vote for president in an open-end question, allowing respondents to say in their own…

  • KFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision

    Perspective

    As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether the law overall will leave their own families better off (26 percent), worse off (33 percent), or if it won’t make much difference (34 percent).…

  • Public Opinion on the ACA: Cruising or Turbulent Ride?

    Perspective

    Regular readers of the Kaiser Health Tracking poll know by now that public opinion on the Affordable Care Act (ACA) has been at a steady cruising altitude since it was signed into law on March 23, 2010, with a little over four in ten viewing the law favorably and a similar share unfavorably. But, has public opinion on the law since passage been more turbulent for different groups of Americans, for example, those with lower…

  • Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision

    Poll Finding

    This Data Note draws from the March 2012 Kaiser Health Tracking Poll and examines people's impressions of how the law and the Court case will affect them, focusing primarily on those groups that are in the position to receive the greatest benefits. For the most part, those that stand to benefit most are not more likely than others to expect to be better off under the law, or to feel that the Supreme Court's decision…

  • Side-by-Side Comparison of Major Health Care Reform Proposals

    Issue Brief

    On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, and a week later, signed into law the Health Care and Education Reconciliation Act of 2010, which made some changes to the comprehensive health reform law. Summary of Final Health Care Reform Law (.pdf) Download a printable comparison of the new health reform law (the Patient Protection and Affordable Care Act), the House-passed Health Care and Education Reconciliation Act…

  • Explaining Health Reform: Eligibility And Enrollment Processes For Medicaid, CHIP and Subsidies in the Exchange

    Issue Brief

    The new health reform law will require most U.S. citizens and legal residents to have health coverage by 2014. It provides new options for coverage by expanding Medicaid eligibility to more low-income people and creating a state-based system of health insurance exchanges through which individuals can purchase coverage, with federal subsidies for many. This brief and accompanying explanatory chart summarize key requirements that states face under health reform to construct coordinated and consumer-friendly enrollment systems…

  • Data Note: Americans’ Satisfaction with Insurance Coverage

    Issue Brief

    This data note explores who is more or less likely to say that they are satisfied with their health insurance plan, examines how people’s opinions of their plan vary with health status and what people’s health care experiences and concerns can tell us about their health coverage. Overall, the Foundation’s August 2009 tracking poll found that most Americans with insurance give their plan a favorable rating, and most are satisfied with various aspects of their…

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • I lost my job and my health coverage. Can I buy a Marketplace plan now, or do I have to wait for the next Open Enrollment?

    FAQs

    You can apply now. HealthCare.gov and all state Marketplaces allow a special enrollment opportunity when people lose other coverage, including job-based coverage. In general, you have 60 days following the loss of other job-based coverage to apply for a special enrollment opportunity through the Marketplace. If you have advance notice of your coverage loss, you can apply for the special enrollment opportunity up to 60 days in advance. If your state uses the federally facilitated Marketplace…