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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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  • Obamacare: The Metrics In The News Are Mostly Wrong

    From Drew Altman

    In this Policy Insights, Kaiser Family Foundation President and CEO Drew Altman explains how the measures of success for year one of Obamacare used in media coverage and national discussion is the equivalent of judging the local weather from national averages.

  • Getting into Gear for 2014: Shifting New Medicaid Eligibility and Enrollment Policies into Drive

    Report

    On January 1, 2014, many key provisions of the Affordable Care Act (ACA) will start to go into effect, including the expansion of Medicaid to low-income adults and the launch of new Medicaid eligibility and enrollment processes, which are designed to move toward a coordinated enrollment system across health coverage programs, including Medicaid, CHIP, and the new Health Insurance Marketplaces. Over the past year, states have made steady and significant progress preparing for these changes,…

  • Kaiser Health Tracking Poll: November 2013

    Feature

    Amid heavy news coverage of problems with the Affordable Care Act's rollout, the November Kaiser Health Tracking Poll finds a significant negative shift in the public's views of the law, with roughly half now holding an unfavorable view and just a third holding a positive one.

  • How Buying Insurance Will Change Under Obamacare

    Perspective

    When the Affordable Care Act’s (ACA) health insurance marketplaces (also known as “exchanges”) go online this October, millions of people are expected to apply for private insurance coverage. Nobody expects the launch will be perfect, with no hitches and problems.  The law not only replaces a fragmented and confusing assortment of plan options in today’s individual insurance market, but it also integrates tax credits to help people pay their premiums, which requires an entirely new…

  • Individual Market Enrollment Ticks Up in Early 2014

    Issue Brief

    This early look at the growth in the individual or nongroup market during the first three months of 2014 uses first quarter enrollment data submitted by insurance companies to state regulators to estimate the size of the market at the end of March. It includes both on and off exchange enrollment and is net of any people leaving the market (whether through plan cancellations or general churn in the market). It does not include the…

  • Potential Supreme Court Decision: Who Will Bear the Coverage “Burdens?”

    Issue Brief

    The Supreme Court is expected to reach a decision by the end of June, 2014 on the cases brought forth by Hobby Lobby and Conestoga Wood Specialties, two for profit corporations challenging the ACA’s contraceptive coverage requirement. The plaintiffs contend that the requirement that they include coverage for certain contraceptive services (emergency contraceptive pills and intrauterine devices) in the insurance plans “substantially burdens” both the corporation’s and the owners’ religious rights. During the arguments, several…

  • Advancing Opportunities, Assessing Challenges: Key Themes from a Roundtable Discussion of Health Care and Health Equity in the South

    Issue Brief

    This brief summarizes the primary themes expressed by participants of a roundtable discussion of current and future opportunities and challenges for advancing health care and health equity in the South organized by Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Georgia.