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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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  • What Worked and What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    Issue Brief

    This brief highlights the experiences of four states—Colorado, Connecticut, Kentucky, and Washington—that established a State-based Marketplace (SBM), implemented the ACA’s Medicaid expansion, and achieved success enrolling eligible individuals into coverage. Based on interviews with key stakeholders in each state, it identifies effective strategies that contributed to enrollment and current priorities looking forward.

  • Webinar: The ACA and What It Means for Black Americans

    Event Date:
    Event

    Now that the Affordable Care Act's major provisions to expand health insurance coverage are in effect, time is ticking for consumers to sign up for a health insurance plan through the Federal or State Health Insurance Marketplaces.  Monday, March 31, is the last day to sign up for coverage through the Marketplaces. While there is no deadline for eligible people to enroll in Medicaid, many consumers are still confused or uninformed about their coverage options…

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    Event Date:
    Event

    On Monday, July 28, the Kaiser Family Foundation held an interactive web briefing to examine the experiences and lessons of four states -- Colorado, Connecticut, Kentucky, and Washington -- that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA.  The briefing drew upon a new issue brief released today by the Foundation’s Kaiser Commission on Medicaid and the Uninsured (KCMU), What Worked and…

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    News Release

    On Monday, July 28 from 1 p.m. to 2:00 p.m. EDT, the Kaiser Family Foundation will hold an interactive web briefing to examine the experiences and lessons of four states - Colorado, Connecticut, Kentucky, and Washington - that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA. The briefing will draw upon a new issue brief released today by the Foundation’s Kaiser Commission…

  • State Marketplace Profiles: New York

    Other Post

    Final update made on September 30, 2013 (no further updates will be made) Establishing the Marketplace After the New York State legislature failed to pass exchange legislation, Governor Andrew Cuomo (D) signed Executive Order 42 on April 12, 2012, to establish the New York Health Benefit Exchange.1  In August 2013, the state announced that the online marketplace would be called NY State of Health.2  Structure: The Executive Order establishes the New York Health Benefit Exchange…

  • State Marketplace Profiles: Maryland

    Other Post

    Final update made on November 13, 2013 (no further updates will be made)  Establishing the Marketplace On April 12, 2011, Governor Martin O’Malley (D) signed SB 182/HB 166 into law establishing the Maryland Health Benefit Exchange (MBHE).1   In May of the following year, Governor O’Malley signed additional Marketplace legislation (SB 372/HB 433) which addressed multiple Marketplace implementation and operational issues and was based on recommendations by the Board of Directors and advisory groups from 2011.2 …