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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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  • Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses Medicaid health home services to coordinate care for high risk/high cost dual eligible beneficiaries with chronic conditions. This policy brief summarizes key aspects of the…

  • Women’s Health and Election 2008

    Issue Brief

     Download PDF Women consistently cite health care as one of the top issues they want the Presidential candidates to address, reflecting their experiences with the health care system as patients, mothers, and caregivers for frail and disabled family members.  Women’s priorities for health care reform cut across many critical topics, including health insurance coverage and affordability, the cornerstones of the candidates’ health proposals, as well as long-term care, delivery system issues, and reproductive health.  This…

  • Health Affairs Article: Florida’s Medicaid Reform: Informed Consumer Choice?

    Report

    Health Affairs Article: Florida's Medicaid Reform: Informed Consumer Choice? Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to make this health plan choice and over half of those who were aware reported difficulty making a plan choice, according to a Health Affairs…

  • Ask the Experts About Reform: Where Are We Now and Where Are We Headed?

    Event Date:
    Event

    The Alliance for Health Reform and Eli Lilly co-sponsored this briefing to have an expanded panel of prominent experts answer questions about the current health reform efforts.Questions addressed include: What is the status of major reform bills? How do they differ from each other, and from the plan that may emerge from the Senate Finance Committee? What are some of the outstanding issues that will need to be decided to get a bill to the…

  • Today’s Topics In Health Disparities: Is the Health Care System Ready for Health Reform?

    Event Date:
    Event

    On Wednesday, November 4, at 1 p.m. ET, this Today's Topics In Health Disparities live webcast examined how ready the health care system is for the influx of newly covered individuals that health reform aims to deliver. In the health care proposals being considered by Congress, changes to Medicaid alone could mean as many as 15 million people would become newly eligible for the program and many live in medically underserved areas. The program will…

  • What’s in There? An Ask-the-Experts Overview of the Health Reform Law

    Event Date:
    Event

    The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 are now law. But many people have questions about the new reforms. To answer questions about the major provisions of these two laws, the Alliance for Health Reform and The Commonwealth Fund sponsored an April 16 briefing. For more information, please visit Alliance's event page. Full Video   Speakers for this session: The panel is co-moderated by Karen…

  • Summary of the Affordable Care Act

    Fact Sheet

    This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.

  • California’s Uninsured on the Eve of ACA Open Enrollment

    Report

    This report presents the findings of a baseline survey of California’s uninsured adult population just before the start of the first open enrollment period under the Affordable Care Act (ACA). It will be followed by three other surveys over the course of the next two years that will capture the changing experiences and attitudes of this same group of 2,000 people over time, whether they obtain coverage or remain uninsured. The report analyzes the uninsured…

  • Kaiser Health Tracking Poll: September 2013

    Feature

    September 2013 Kaiser Health Tracking Poll gauges public opinion on the ACA days before open enrollment for Obamacare health insurance marketplaces begins.