Affordable Care Act

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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  • Poll: 7 in 10 Want the Trump Administration to Make the Affordable Care Act Work Rather Than Make it Fail

    News Release

    As the Trump administration begins implementing Thursday’s executive order aimed at providing alternatives to the Affordable Care Act’s marketplace plans, a new Kaiser Health Tracking Poll finds a large majority of the public (71%) want President Trump and his administration to do what they can to make the current law work. Fielded just prior to Thursday’s executive order, the poll finds fewer Americans (21%) say that the president and his administration should do what they…

  • Kaiser Health Tracking Poll – October 2017: Open Enrollment and the ACA Marketplaces

    Poll Finding

    The October Kaiser Health Tracking Poll focuses on the Affordable Care Act’s (ACA) marketplaces as the November 1st open enrollment period approaches, amidst a period of uncertainty on the future of the individual market. The survey finds the majority of the public think it is more important for President Trump and Congress to work on legislation to stabilize the marketplaces rather than continue efforts to repeal and replace the ACA. A majority – across parties…

  • Survey: Adjusting to Sudden Reduction in Federal Funds, ACA Navigators Expect to Decrease Services

    News Release

    Many navigator organizations responsible for helping consumers understand and sign up for health coverage in 2018 Affordable Care Act (ACA) marketplaces say steep federal funding reductions that recently took effect will likely force them to limit their geographic service area, cut back outreach and public education, lay off staff members, and curtail other assistance, according to a new Kaiser Family Foundation survey of such programs. The navigators’ planned adjustments are in response to the government’s…

  • Data Note: Changes in 2017 Federal Navigator Funding

    Issue Brief

    This data note analyzes federal funding changes for Affordable Care Act (ACA) marketplace navigators in 2017 and discusses the implications for both the navigators and consumers. It presents results of a Kaiser Family Foundation online survey of federal marketplace (FFM) navigator programs and includes insights from a roundtable meeting of more than 40 navigators co-hosted by the Robert Wood Johnson Foundation and Kaiser Family Foundation.

  • Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion

    Interactive

    As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2017 ACA marketplace health plan and the political party of each district’s representative as of October 2017. The analysis also includes maps charting the total number of people enrolled under the ACA Medicaid expansion in…

  • Puerto Rico: Fast Facts

    Fact Sheet

    Puerto Rico: Fast Facts provides a quick snapshot of the island's demographic, health, and economic characteristics. It also provides some information on federal Medicaid rules, infrastructure, and fiscal challenges ahead.

  • Public Opinion on ACA Replacement Plans: Interactive

    Interactive

    This interactive includes nationally representative polls of adults in the U.S. that ask about views of plans to replace the Affordable Care Act. See the interactive table for variations in question wording as well as the individual polls included.

  • Public Ranks Children’s Health Insurance, Marketplace Stabilization Higher Priorities than ACA Repeal

    News Release

    Majorities Support Buy-In Ideas for Medicaid and Medicare Among health priorities facing urgent deadlines in Washington in September, the public ranks repeal of the Affordable Care Act lower than reauthorizing funding for the Children’s Health Insurance Program (CHIP) and stabilizing individual health insurance marketplaces established by the ACA, the Kaiser Family Foundation’s new tracking poll finds. About seven in 10 Americans -- and majorities across parties -- say it’s “extremely” or “very” important to reauthorize…