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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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  • ¿Cuánto es el subsidio para costos compartidos?

    FAQs

    Esto depende del ingreso del hogar y de dónde vive. Para dar una idea general, un plan de Plata típico debería tener, por ejemplo, un límite anual de gasto de bolsillo sobre todos los costos compartidos de $10.600 en 2026. Pero si su ingreso está entre el 100% y 150% del nivel federal de pobreza (un ingreso familiar anual de entre $15.650 y $23.475 para un solo individuo en 2026), las reducciones de costos compartidos…

  • ¿Puedo comprar o cambiar de plan privado de salud por fuera del período de inscripción?

    FAQs

    En general, puede tener una oportunidad especial de inscripción, para cobertura no grupal, durante el año, por fuera del período de inscripción abierta, si experimenta un evento que califique.  Basta con que solo una persona en un hogar que solicita cobertura o asistencia financiera a través del mercado de seguros califique para un período especial de inscripción (SEP) para que todo el hogar califique. El enlace que encontrará aquí le brinda información detallada sobre los…

  • ¿Qué pasa si quiero salir de un plan de salud del mercado de seguros durante el año?

    FAQs

    Es importante que contacte a ambos, al mercado de seguros y a su plan, para informarles que ya no necesita la cobertura. En los estados que utilizan cuidadodesalud.gov puede loguearse en su cuenta, seleccionar la opción "terminación de cobertura", y escribir la información que se requiera. Si tiene un plan familiar y quiere sacar a una persona del plan pero mantener la cobertura para otros, en los estados que usan cuidadodesalud.gov, ingrese en su cuenta…

  • I’m not sure how long ago my Medicaid ended. Is there a deadline for applying for Marketplace coverage?

    FAQs

    Yes, the special enrollment period due to loss of Medicaid or CHIP is 90 days in most states, which means consumers will have up to 90 days after loss of Medicaid or CHIP to enroll in Marketplace coverage. If you do not apply for Marketplace coverage within this timeframe, you may have to wait until the next Open Enrollment Period to enroll in Marketplace coverage. States that run their own Marketplaces can choose to extend…

  • Recibí un Formulario 1095-B por correo. ¿Qué es?

    FAQs

    Las aseguradoras, ciertos planes de salud patrocinados por el empleador y programas de salud pública como Medicaid pueden proporcionarle documentación que indique los meses del año anterior en los que estuvo cubierto por el plan. Los proveedores de cobertura pueden enviarle el Formulario 1095-B directamente, pero en algunos casos, es posible que deba pedirlo a su proveedor. Si usted estaba inscrito en la cobertura familiar, el formulario 1095-B indicará los nombres de todos los miembros…

  • The Rubber is About to Hit the Road on Medicaid Cuts

    Quick Insights

    Once Republicans in Congress get specific about Medicaid cuts, it will become more tangible and clearer who will be affected. Changes to the status quo in health care rarely get more popular when the details get filled in.

  • The Debate About Enhanced Premium Tax Credits Begins to Emerge (Finally)

    From Drew Altman

    In his latest column, president and CEO Drew Altman discusses why debate about extending the ACA enhanced tax credits set to expire this year has been slow to develop, and why it could matter to Republicans politically if the tax credits are not extended.

  • Me faltan algunos años para cumplir 65 años y ser elegible para Medicare, y mientras tanto me gustaría inscribirme en un plan del mercado de seguros. Soy inmigrante, residente legal, y he oído que hay u...

    FAQs

    En general, los inmigrantes con estatus legal (excepto los beneficiarios de DACA) pueden adquirir un plan en el mercado de seguros establecidos por la Ley de Cuidado de Salud a Bajo Precio (ACA). La nueva ley no afecta la elegibilidad para la cobertura del mercado de seguros para estos inmigrantes. Actualmente, dependiendo de sus ingresos y el tamaño de su hogar, podría ser elegible para subsidios para compensar el costo de sus primas. Sin embargo,…

  • Pulling it Together: Separating the Forest from the Trees in the Health Reform Debate

    Perspective

    The good news for those who care about health care is that the issue is rising again on the national agenda. If we have a big debate about health in the presidential campaign and if it is a factor at the polls in 2008, it will help create a mandate for the new president and Congress to make health care a priority in 2009. But the real health care debate has been delayed by the…