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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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  • The Health Care Priorities and Experiences of California Residents

    Report

    This survey by the Kaiser Family Foundation and California Health Care Foundation gauges California residents’ views on health care priorities facing the state’s new governor and legislature, including health care affordability, access to care, mental health and substance use treatment, and provider shortages. It also highlights Californians’ experiences in the health care system, as well as views on the Affordable Care Act, Covered California, Medi-Cal, and proposals to advance a single-payer health insurance system in…

  • Testimony: Pre-Existing Conditions and Health Insurance

    Issue Brief

    KFF's Karen Pollitz testimony before the U.S. House Committee on Ways and Means on Jan. 29, 2019 examines the prevalence of pre-existing conditions, the impact of the Affordable Care Act's prohibition against medical underwriting and other provisions aimed at stabilizing the insurance risk pool, and the trade-offs involved in relaxing those provisions. 

  • The Future of Medicare Advantage: Are We on the Right Path?

    Event Date:
    Event

    This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act's reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.

  • Los YouToons se preparan para Obamacare

    Video

    Antes del inicio del período de inscripción abierta, el 1 de octubre, la Kaiser Family Foundation presenta un video en español para que el público comprenda mejor los cambios que vienen próximamente bajo la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act o ACA, en inglés). “Los You Toons Se Preparan para Obamacare” explica las nuevas opciones que tendrán los estadounidenses para obtener seguro médico en el año 2014. /// Before the…

  • First Wave of Major New Survey Project on California’s Uninsured

    News Release

    California’s Uninsured Struggle With Costs and Access And Say They Want Insurance, But Most Have Heard Little About The Affordable Care Act, And Many Who Are Likely To Be Eligible For Medi-Cal or Exchange Subsidies Don’t Know It Many Undocumented Immigrants in CA Think They Will Get Coverage Through the ACA But Won’t Menlo Park, Calif. – California’s uninsured are skipping medical care, struggling with costs and want coverage, but many report knowing little about…

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy…

  • ¿Qué debo hacer para prepararme para renovar Medicaid?

    FAQs

    Debe comunicarse con la agencia estatal de Medicaid para asegurarse que su dirección postal, dirección de correo electrónico y número de teléfono registrados estén actualizados. Dependiendo de su estado, es posible que pueda actualizar esta información a través de su cuenta en línea.

  • Recibí un Formulario 1095-A del mercado. ¿Qué es?

    FAQs

    El formulario 1095-A le brinda información sobre el monto del crédito fiscal avanzado para primas (APTC) que se pagó durante el año a su plan de salud para reducir su prima mensual. Esta información también fue reportada al IRS. El APTC pagado en su nombre durante el año se basó en el ingreso anual que estimó que ganaría cuando se inscribió en la cobertura del mercado de seguros de salud. Ahora debe presentar una declaración…