Affordable Care Act

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

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Poll: Public Divided on Repealing Obamacare, But Few Want It Repealed Without Replacement Details

    News Release

    As Congress begins to work on repealing and replacing the Affordable Care Act, the latest Kaiser Health Tracking Poll finds that one in five Americans (20%) support repeal alone, while three quarters either oppose repeal altogether (47%) or want to wait to repeal the law until the replacement plan’s details are known (28%). Overall, the poll finds that nearly equal shares say that the next Congress should vote to repeal the law (49%) and that…

  • Current Flexibility in Medicaid: An Overview of Federal Standards and State Options

    Issue Brief

    The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would…

  • Kaiser Health Tracking Poll: May 2014

    Feature

    More than four years after the Affordable Care Act's enactment and more than a month after the close of open enrollment, six in 10 Americans say the health reform law has not had an impact on them or their families, Kaiser’s May Tracking Poll finds. Among those who say it has, Republicans are much more likely to say their families have been hurt by the law than helped, while Democrats are more likely to say…

  • Kaiser Health Policy News Index: May 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month’s Index finds that news about the Affordable Care Act (ACA) enrollment numbers was followed by more than half the public, ranking behind two non-health news stories (the kidnapping of Nigerian schoolgirls and the ongoing conflict between…

  • Majority of the Public Say They Haven’t Been Affected By the Health Reform Law

    News Release

    Democrats More Likely to Say They Have Been Helped By the Law, Republicans More Likely to Say They Have Been Hurt Republican Voters Want ACA Debate to Continue, Democrats Would Rather Hear Candidates Talk About Issues Like Jobs, Independents Are More Split More than four years after the Affordable Care Act's enactment and more than a month after the close of open enrollment, six in 10 Americans (60%) say the health reform law has not…

  • Survey of Non-Group Health Insurance Enrollees

    Report

    Executive Summary January 1, 2014 marked the beginning of several provisions of the Affordable Care Act (ACA) making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces (also known as “Exchanges”) and the availability of premium and cost-sharing subsidies for individuals with low to moderate incomes. Data from the Department of Health and…

  • Health Care Costs: A Primer

    Issue Brief

    This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers.

  • Year Two of the ACA Coverage Expansions: On-the-Ground Experiences from Five States

    Issue Brief

    This brief provides an on-the-ground view of ACA implementation after completion of the second open enrollment period. It is based on 40 in-person interviews conducted in five states that have made different implementation choices, including three states (Colorado, Kentucky, and Washington) that have developed a State-based Marketplace and adopted the Medicaid expansion and two states (Utah and Virginia) that rely on the Federally-facilitated Marketplace (FFM) for enrollment of individuals into qualified health plans (QHPs) and…

  • What a Break in the Obamacare Battles Could Bring

    News Release

    Following the Supreme Court’s King v. Burwell decision, the Affordable Care Act could use a break from the intense political heat, though it may not get a long one as the 2016 election season heats up and presidential candidates play to their bases on health care, writes Drew Altman in his latest column for The Wall Street Journal’s Think Tank. All previous columns by Drew Altman are available.

  • Kaiser Health Tracking Poll: April 2014

    Feature

    Despite the news that 8 million people have signed up for health insurance through the ACA’s new marketplaces, the April Kaiser Health Tracking Poll finds no change in overall opinion of the law since last month . The most common reason for remaining uninsured is not being able to find an affordable plan. Also, a majority of the public supports the ACA’s requirement that private health insurance plans cover the full cost of birth control…