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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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  • State Marketplace Profiles: Illinois

    Other Post

    Final update made on October 15, 2013 (no further updates will be made) Establishing the Marketplace While Governor Pat Quinn (D) had considered establishing a state-based marketplace via executive order, he began moving in the direction of a state-federal partnership marketplace in July 2012.1 ,2  While the state has established a Partnership Marketplace, the administration still intends to transition to a fully State-based Marketplace in 2015 and will continue with the necessary planning. Illinois will be…

  • State Exchange Profiles: New Jersey

    Other Post

    Final update made on December 10, 2012 (no further updates will be made) Establishing the Exchange  On December 7, 2012, Governor Chris Christie (R) vetoed A 3186/S 2135, which would have established a health insurance exchange within the Department of Banking and Insurance and announced that the state would default to a federal exchange.1Governor Chris Christie (R) vetoed similar legislation earlier in 2012.2 In 2011, the New Jersey Interagency Working Group on the ACA, led…

  • State Exchange Profiles: Oklahoma

    Other Post

    Final update made on December 13, 2012 (no further updates will be made) Establishing the Exchange  On November 19, 2012, Governor Mary Fallin (R) announced that Oklahoma would not pursue the creation of a state-based health insurance exchange.1 Prior to the announcement, Oklahoma had established the Joint Committee on Federal Health Care Law to explore the state’s options regarding federal health reform, including exchange implementation in the state.2 The Joint Committee convened in 2011 and released final exchange…

  • Analysis: Opportunities Under the ACA for Addressing Intimate Partner Violence Among Women With HIV

    News Release

    An estimated 36 percent of women in the U.S. report having experienced intimate partner violence (IPV), also called domestic violence, but among HIV positive women 55 percent report such experiences. A new Kaiser Family Foundation analysis looks at opportunities to address IPV in the Affordable Care Act (ACA) that could help women who are HIV positive or at risk for HIV. The analysis, HIV, Intimate Partner Violence and Women: New Opportunities Under the Affordable Care Act, looks…

  • YouToons: Health Insurance Explained

    Health Insurance Explained: The YouToons Have it Covered

    Video

    In this five-minute animated video, the YouToons help consumers understand their health insurance through fun, easy-to-understand explanations and scenarios. This cartoon serves as a tutorial for consumers and organizations. The YouToons previously appeared in the 2010 animated movie, "Health Reform Hits Main Street" and the 2013, "The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act."

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • Health Reform: Lessons From Massachusetts

    Event Date:
    Event

    As Congress debates comprehensive national health reform, the Kaiser Family Foundation has two reports and an updated fact sheet that examine state-level health reform in Massachusetts and the lessons it offers for policymakers in Washington. Consumers’ Experience in Massachusetts: Lessons For National Health Reform and In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts, examine the impact of health reform on the lives of ordinary people in the state, including…

  • Data Note: California’s Young Uninsured – A Look at 19- to 34-Year Olds Pre-ACA Rollout

    Poll Finding

    A Data Note based on the Kaiser Family Foundation California Uninsured Baseline Survey In California, as across the United States, the young uninsured are a key piece of the new Affordable Care Act (ACA) marketplace puzzle. Having a good-sized component of young people, with their generally more robust health and less frequent need for medical care and prescription drugs, in the newly created insurance pools would provide an important counterbalance to the incoming group of…

  • Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California

    Issue Brief

    This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.

  • How Will the Uninsured Fare Under the Affordable Care Act?

    Fact Sheet

    This report explains how the ACA expands coverage nationally, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people are eligible for Medicaid or financial assistance in the Marketplace. For states…