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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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  • KFF February Health Tracking Poll: Nearly Half Confused About Status of the Health Reform Law

    Perspective

    The latest Kaiser Health Tracking poll finds that amid a public debate about contraceptive coverage in insurance plans, 63 percent of Americans support a new federal requirement that plans include no-cost birth control, while a third oppose it. Catholics split along similar lines, but there’s a big partisan divide, including among women: 85 percent of women who are Democrats support the requirement, compared with 42 percent of women who are Republicans. The public is also divided…

  • Kaiser Survey Probes Health Insurance Brokers’ Views on Insurance Trends, ACA

    Perspective

    A new nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets by the Kaiser Family Foundation explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums and deductibles for individuals and small businesses purchasing health insurance. When asked to estimate what they expect to be the typical premium increase in 2012…

  • Data Note: A Snapshot of Public Opinion on the Individual Mandate

    Poll Finding

    For the two years since the law's passage, and during the debate leading up to it, the individual mandate has been one of the most controversial aspects of the law. As the lawyers, policy makers, ACA opponents and supporters focus intently on the Supreme Court hearings, this Data Note looks at what the general public thinks of the mandate, explores the reasons why favorability ratings have been so low, and suggests that while opinion on…

  • State Variation and Health Reform: A Chartbook

    Report

    This chartbook pulls together data related to state variation in key areas such as major industry types, poverty and unemployment rates and fiscal conditions; health coverage and the uninsured; Medicaid and CHIP eligibility and enrollment; Medicaid spending and financing; access to Health Care; health care costs; and insurance markets.

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

    Fact Sheet

    This state report explains how the ACA expands coverage in Kentucky, 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 in Kentucky are eligible for Medicaid or financial assistance in…

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

    Fact Sheet

    This state report explains how the ACA expands coverage in Missouri, 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 in Missouri are eligible for Medicaid or financial assistance in…

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

    Fact Sheet

    This state report explains how the ACA expands coverage in Arizona, 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 in Arizona are eligible for Medicaid or financial assistance in…