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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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  • Kaiser Health Tracking Poll – January 2018: The Public’s Priorities and Next Steps for the Affordable Care Act

    Feature

    With the 2018 midterm elections still about ten months away, the January Kaiser Health Tracking poll examines what issues voters most want 2018 midterm candidates to talk about during their upcoming campaigns. Health care is at the top of a group of issues but health care is less important to Republicans and among voters in battleground states. While Congress is currently debating a budget to keep the government funded beyond February 8, 2018, the poll…

  • Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

    News Release

    Public Grows More Pessimistic About How Repeal Will Affect Them Personally Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill or not pass it all, finds the latest Kaiser Health Tracking Poll. Three in 10 (31%) of the public hold favorable views of the American…

  • Coronavirus Response and the Affordable Care Act

    Policy Watch

    This post examines the Affordable Care Act's impact 10 years after its enactment and how its provisions, especially those that expand coverage opportunities, could address the health threat and economic upheaval caused by the coronavirus pandemic.

  • KFF Health Tracking Poll – Early April 2020: The Impact Of Coronavirus On Life In America

    Report

    Fielded from March 25-30, this poll tracks how the rapidly unfolding coronavirus (COVID19) pandemic is affecting Americans, including health and economic impacts to date and worries about the future. This poll also examines the implications of the pandemic on the 2020 presidential election, including favorability of the ACA, Medicare-for-all and a public option.

  • Assessing the Performance of the U.S. Health System

    Issue Brief

    Health spending growth has consistently outpaced U.S. economic growth and is higher than medical spending in other wealthy countries. Despite spending more, the United States doesn't have better health outcome in terms of life expectancy, mortality rates and other measures. This brief provides an overview of trends in health costs and the performance of the U.S. health system, including comparisons to countries from the Organisation for Economic Co-operation and Development (OECD). The brief charts growth…

  • Majority Favors the Affordable Care Act’s Employer Mandate, But Opinion Can Shift When Presented With Pros and Cons

    News Release

    Recent news stories on the heath law did not attract most Americans’ attention, and many are unaware of details and implications of the developments Weeks before the Affordable Care Act’s employer mandate takes effect in January, a new Kaiser Family Foundation tracking poll finds that six in 10 Americans (60%) say they have a favorable view of the provision, which in 2015 requires employers with 100 or more full time workers to offer health coverage…

  • Remember the People Outside of the Exchanges

    Perspective

    There has been a substantial amount of focus on the recently released draft regulations governing state-based health insurance exchanges under the Affordable Care Act (ACA). And that's appropriate, since the exchanges have the important roles under reform of providing consumers with easier access to insurance and facilitating tax credits and cost-sharing subsidies that make coverage more affordable. But, as central as exchanges will likely be, it's important to remember that there are other key provisions that help…

  • Non-Voters and Health Reform: Indifference and Confusion Over the New Law

    Perspective

    The latest Kaiser Health Tracking Poll assessed the role health reform played in voters’1 decisions in the midterm elections and the public’s overall mood towards the health reform law. This blog post focuses on a different group, people who say they are not registered or did not vote in last week’s election, and examines how their views on the health reform law differ from those that said they did vote. As is usually the case,…

  • Americans Remain Divided on Health Reform But Are Confused About The Law And How And When It Will Affect Them

    News Release

    Many Provisions That Take Effect in 2010 Are Popular and Have Bipartisan Support Cable News Tops List of the Public’s “Most Important” Information Sources MENLO PARK, Calif. –The first Kaiser Health Tracking Poll fielded since the passage of health reform last month finds that 8 in 10 Americans know that President Obama signed the legislation  into law.  But 55 percent say they are confused about the law and more than half (56%) say they don’t yet have…

  • The ACA and Fluoridation: The Power of Political Symbols

    Perspective

    In the 1950s, water fluoridation became a public health controversy that morphed into a symbolic issue of larger proportions. For its opponents, fluoridation came to symbolize big government and even for some, a communist threat. The controversy became so odd that it was parodied in Stanley Kubrick’s 1964 film “Dr. Strangelove,” in which General Jack Ripper starts a nuclear war to stop a communist plot to “sap and impurify all of our precious bodily fluids”…