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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

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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  • Medicaid’s Role in Colorado

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Colorado. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Colorado.

  • What’s the Near-Term Outlook for the Affordable Care Act?

    News Release

    With congressional Republicans’ efforts to repeal the Affordable Care Act on hold, a new issue brief from the Kaiser Family Foundation answers questions about the current state of the 2010 health law, zeroing in on the individual insurance marketplaces that the law established. Questions addressed by the brief include: Is Obamacare failing? How would administrative actions affect market stability? What happens if the market fails? What might be done to strengthen the Marketplaces?

  • ANALYSIS: ACA Silver Plan Premium Increases from 7% to 38% Attributed to End of Cost-Sharing Payments

    News Release

    Insurers factored in premium increases ranging from 7 percent to 38 percent exclusively in silver plans to absorb the financial impact of the loss of cost-sharing reduction payments from the federal government, a new Kaiser Family Foundation analysis finds. The approach, used by insurers in many states, shields consumers from steep rate hikes, because tax credits defraying the cost of premiums rise dollar-for-dollar along with benchmark silver rates. Eighty-four percent of marketplace enrollees received premium…

  • ACA Mandate Repeal May Be Less Popular Than GOP Thinks

    From Drew Altman

    In this Axios column, Drew Altman discusses how public opinion seems to flip on eliminating the individual mandate as part of the tax legislation, from for it to against, when the public considers the consequences.

  • Kaiser Health Tracking Poll – January 2018: The Public’s Priorities and Next Steps for the Affordable Care Act

    Feature

    With the 2018 midterm elections still about ten months away, the January Kaiser Health Tracking poll examines what issues voters most want 2018 midterm candidates to talk about during their upcoming campaigns. Health care is at the top of a group of issues but health care is less important to Republicans and among voters in battleground states. While Congress is currently debating a budget to keep the government funded beyond February 8, 2018, the poll…

  • KFF Health Tracking Poll – Early April 2020: The Impact Of Coronavirus On Life In America

    Report

    Fielded from March 25-30, this poll tracks how the rapidly unfolding coronavirus (COVID19) pandemic is affecting Americans, including health and economic impacts to date and worries about the future. This poll also examines the implications of the pandemic on the 2020 presidential election, including favorability of the ACA, Medicare-for-all and a public option.