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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 ACA Family Glitch and Affordability of Employer Coverage

    Issue Brief

    This analysis estimates that 5.1 million people fall into the Affordable Care Act's "family glitch," which occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. It explores the demographic characteristics of this group, including state-level estimates.

  • Already at Record High, ACA Marketplace Enrollment Could Increase Further

    News Release

    Enhanced Marketplace subsidies have continued to drive up enrollment in the individual market, and the loss of Medicaid coverage by millions of people could contribute to this trend, according to a new KFF analysis. Meanwhile, enrollment in non-ACA-compliant plans is at a record low. As of early 2023, an estimated 18.2 million people have individual market coverage, the highest since 2016. Individual market enrollment grew by about 29% between early 2020 and early 2023 —…

  • Fui a la farmacia para renovar mi receta y me enteré que mi cobertura de Medicaid había terminado. No recibí ningún aviso de Medicaid. ¿Qué hago ahora?

    FAQs

    Si ha perdido Medicaid pero cree que aún califica, comuníquese con su agencia de Medicaid. Si su cobertura terminó hace menos de 90 días, es posible que pueda enviar los formularios y documentos requeridos y restablecer su cobertura. En este caso, su cobertura será retroactiva a su fecha de baja. Si su cobertura terminó hace más de 90 días, es probable que deba volver a solicitar Medicaid. También puede solicitar un seguro médico privado a…

  • El plan de salud de mi empleador tiene una opción de bienestar que me obliga a pagar una prima más alta si no cumplo con ciertos objetivos de salud o si no participo en absoluto. No puedo pagar esas pri...

    FAQs

    Eso depende. Si su contribución a la prima con la penalización por bienestar sería superior al 9.96% de sus ingresos en 2025, entonces el plan de su empleador se consideraría inasequible y usted sería elegible para solicitar créditos fiscales para las primas en el mercado de seguros. Esta prueba se aplica independientemente de que usted sea realmente sancionado o no, y antes de que se aplique la sanción (por ejemplo, si su empleador le da…

  • Un aviso de mi aseguradora indica que mi plan no se volverá a ofrecer el próximo año. ¿Ahora que hago?

    FAQs

    Durante la inscripción abierta, puede buscar un plan diferente. Debe inscribirse para obtener una nueva cobertura durante la inscripción abierta para permanecer asegurado el próximo año y recibir el crédito fiscal para ayudar a pagar sus primas lo más preciso posible. Si no actúa antes de que finalice la inscripción abierta y vive en un estado que utiliza cuidadodesalud.gov, el mercado lo inscribirá automáticamente en un nuevo plan. El mercado intentará elegir el plan de…

  • What to Watch in the 2024 ACA Open Enrollment

    Policy Watch

    With the start of the 2024 Affordable Care Act open enrollment, the Marketplaces have been operating for a full decade and are heading into their eleventh year. This policy watch outlines changes to watch out for during 2024 Open Enrollment.

  • As Open Enrollment Begins, KFF’s Updated Subsidy Calculator and 300+ FAQs Demystify ACA Marketplaces

    News Release

    A recent KFF survey found one-in-three people with Marketplace coverage say it is somewhat or very difficult to find a plan that meets their needs. With ACA enrollment beginning November 1, KFF has updated its most-used Marketplace tools and published an explainer on key changes and issues to watch in this year’s open enrollment season. Tools for Open Enrollment>> KFF’s Health Insurance Marketplace Calculator provides estimates of 2024 health insurance premiums and subsidies for people…

  • The New Health Care Agenda: Gridlock, Lots of Hearings

    From Drew Altman

    In an Axios column, Drew Altman analyzes what the midterm election means for the health policy agenda between now and 2020--mostly political positioning and gridlock in Congress, with most of the action affecting people in the states. 

  • More Insurers Are Participating in the ACA Marketplaces in 2019

    News Release

    Insurer participation in the Affordable Care Act’s health insurance marketplaces is rising in 2019, finds a new analysis from KFF (the Kaiser Family Foundation).The increase follows consecutive years of improving insurance company profits and shows up in several different ways: Going into 2019, 608 counties nationwide are gaining at least one insurer in the marketplace, while only five counties will lose an insurer. In 2019, roughly 17 percent of enrollees (living in 37 percent of…