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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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  • Issue Briefs and Testimony Related to Health Reform

    Issue Brief

    Issue Briefs Related to Health Reform This collection of some of our most recent and relevant issue briefs go beyond the basics to provide concise discussions and analyses of key policy topics related to health reform. For a more complete collection of all the Foundation's health reform resources, click here.Health Reform Roundtables: Charting A Course Forward Health Reform Roundtables: Charting A Course Forward is a series of discussions among federal officials, state officials and outside…

  • Understanding How States Access the ACA Enhanced Medicaid Match Rates

    Issue Brief

    This brief reviews the rules around the enhanced federal medical assistance percentages (FMAP) provided in the Affordable Care Act (ACA), the process for states to claim the enhanced matching funds and a discussion about what information the new data will provide looking forward.

  • Public Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage

    Feature

    PublicOpinionSinglePayerKFF Download For many years, Kaiser Family Foundation has been tracking public opinion on the idea of a national health plan (including language referring to Medicare-for-all since 2017). Historically, our polls have shown support for the federal government doing more to help provide health insurance for more Americans, though support among Republicans has decreased over time (Figure 1). But this never translated into majority support for a national health plan in which all Americans would…

  • New Chart Collection Examines the Public’s Malleable Views Around a National Health Plan and Expanding Access to Medicare

    News Release

    For many years, the Kaiser Family Foundation has been tracking public opinion on the idea of national health plan. Since the 2016 Democratic presidential primary and Sen. Bernie Sanders’ rallying cry for “Medicare-for-all,” our polls have shown a modest increase in support for the idea of a national health plan, and broad support for proposals that expand Medicare. At the same time, our polls also show that support can quickly erode when people hear further…

  • Poll: Two-thirds of Voters Say a Candidate’s Position on Pre-existing Conditions is Important to their Vote, More than Say the Same about Drug Costs, ACA Repeal or Medicare-for-All

    News Release

    About two-thirds (65%) of voters say a candidate’s support for continued protections for people with pre-existing health conditions is either the “single most important factor” or “very important” to their vote in the upcoming midterms elections, finds the latest Kaiser Family Foundation tracking poll. That’s a larger share than says the same about other health care issues, including bringing down prescription drug costs (58%), repealing the Affordable Care Act (53%), stabilizing the ACA marketplaces (52%), or…

  • Most Americans – Across Parties – Say 2018 Candidates’ Position on Pre-Existing Condition Protections Will Matter to Their Vote; Do Not Want Supreme Court to Overturn These ACA Protections

    News Release

    Half in Non-Expansion States Support Their State Expanding Medicaid; More if Tied to Work Requirements With less than four months to go until the Congressional midterm general election, a candidate’s position on continuing protections for people with pre-existing health conditions is at the forefront of the many health care issues on voters’ minds, finds the latest Kaiser Family Foundation tracking poll. Continuing pre-existing condition protections ranks first among six other candidate positions on health care…

  • Compare Medicare-for-all and Public Plan Proposals

    Interactive

    This side-by-side interactive compares 10 bills to expand public health coverage through Medicare-for-All, a public option and other approaches, that have been introduced in the current Congress. The interactive allows users to compare these proposals across a number of dimensions, including eligibility, benefits, cost sharing, provider payments, and more.

  • Findings of Kaiser Health Tracking Poll: Election 2008 — October 2008

    Poll Finding

    This document contains the key findings from the October Kaiser Health Tracking Poll: Election 2008 poll. The poll involved a nationally representative random sample of 1,217 adults ages 18 and older, including 1,115 adults who say they are registered to vote, who were interviewed by telephone between October 8 and 13, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points and plus or minus 4 percentage points…

  • Chartpack: Kaiser Health Tracking Poll — September 2009

    Poll Finding

    This document contains the chartpack from the September Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted August 4 through August 11, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 123 who had no landline telephone) were carried out in English and Spanish. The margin of…