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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • Consumer Choice in Health Care: How Could Reform Affect Our Choices? How Could We Make Better Choices?

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    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this event which brought together nationally known health policy experts for a conversation on consumer choice in health care. Panelists addressed the following questions: Why is choice of health care providers important? How much choice do we really have now? How much choice do we need? How might health reform affect our choices? In some instances, do we have too much choice? How…

  • The Public’s Policy Agenda for the 113th Congress: Briefing and Panel Discussion

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    As the 113th Congress is sworn in, and President Barack Obama begins his second term of office, a comprehensive new Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health survey queried the public about their priorities for, and views on, a wide range of health and health policy issues. These include issues that will preoccupy federal lawmakers, such as the role of Medicare in the deficit reduction debate, as well as issues currently being…

  • Health Care on the Brink of the Fiscal Cliff

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    The Alliance for Health Reform and the Kaiser Family Foundation present a November 16 briefing to discuss the components of this key policy crossroads with a particular emphasis on the implications for health programs and the health care industry. Automatic cuts would not apply to Medicaid, but Medicare providers would experience 2 percent payment cuts. The reductions would likely be larger for discretionary health programs, such as those funded as part of the National Institutes…

  • Behavioral Health: Can Primary Care Help Meet the Growing Need?

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    The health reform law has specific provisions covering mental health and substance use conditions, as well as general provisions to benefit those in need of behavioral health services. While addressing unmet needs, the reform law provisions raise new challenges. Given their budgetary constraints, will states be able to expand capacity to meet the demands of increased enrollment? Will sacrifices in other benefits and services be needed in order to provide mental health parity? Will the…

  • Making Health Care Work for American Families: Medicaid and Access to Care

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    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Foundation's Commission on Medicaid and the Uninsured, testified March 24, 2009, before the House Energy and Commerce Subcommittee on Health as part of a hearing entitled “Making Health Care Work for American Families: Access to Care." Rowland, appearing as part of a panel, addressed why Medicaid can be a platform for health care reform and can be instrumental in efforts…

  • Addressing Disparities in Health and Health Care — Issues for Reform

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    Marsha Lillie-Blanton, Dr.P.H., Kaiser senior advisor on race, ethnicity and health care, testified before the House Ways and Means Health Subcommittee about the role of health insurance in reducing disparities in health care and in health status. The testimony is part of an ongoing health reform hearing series. Testimony (.pdf) Slides (.ppt)

  • Today’s Topics In Health Disparities: What Might Health Reform Mean for Women of Color?

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    This December 16, 2009, Today's Topics In Health Disparities webcast examined aspects of the current Senate and House health reform bills that particularly impact women of color. Women tend to be greater users of the health care system than men, have higher rates of some chronic illnesses, and have unique reproductive health care needs. Women also tend to take the lead when it comes to obtaining health care for their family members. Provisions such as…

  • The Part D Experience: What are the Lessons for Broader Medicare Reform?

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    Launched in 2006, Medicare added a prescription drug benefit that relies entirely on private plans, while, for other benefits, beneficiaries have a choice between private health plans and traditional fee-for-service Medicare. As policymakers consider changes to Medicare that would give an even greater role to private health plans in caring for Medicare’s nearly 50 million seniors and people with disabilities, the Kaiser Family Foundation hosted a policy workshop to examine how the Part D experience…