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The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Medicaid’s Role in West Virginia

    Fact Sheet

    This fact sheet provides data on Medicaid's role in West Virginia. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect West Virginia.

  • Medicaid’s Role in Tennessee

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Tennessee and describes how implementing a per capita cap or block grant would affect Tennessee.

  • Medicaid’s Role in Alaska

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Alaska. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Alaska.

  • Medicaid’s Role in Colorado

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Colorado. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Colorado.

  • Medicaid’s Role in Nevada

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Nevada. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Nevada.

  • Medicaid’s Role in Louisiana

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Louisiana. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Louisiana.

  • Senate Health Bill Proposes Big Changes to Medicaid Beyond Repealing and Replacing the ACA

    News Release

    The Better Care Reconciliation Act (BCRA) under consideration in Congress includes provisions that would fundamentally change Medicaid by phasing out extra federal funding for states’ Medicaid expansions and for the first time limiting federal spending on Medicaid through a per enrollee cap on financing or a block grant for certain adults. While those measures account for most of the bill’s $756 billion reduction in federal Medicaid spending over the next decade, there are other big…

  • Medicaid Changes in Better Care Reconciliation Act (BCRA) Go Beyond ACA Repeal and Replace

    Issue Brief

    Both the Senate's Better Care Reconciliation Act of 2017 (BCRA) and the House's American Health Care Act (AHCA) go beyond repeal and replacement of the Affordable Care Act (ACA) to make fundamental changes to Medicaid by setting a limit on federal funding through a per capita cap or block grant. The BCRA also includes additional changes that would further reduce federal spending for states with high per enrollee spending, limit state financing mechanisms, allow states…

  • State-by-State Estimates of Reductions in Federal Medicaid Funding Under Repeal of the ACA Medicaid Expansion

    Issue Brief

    Congressional debate around the Affordable Care Act (ACA) has recently included a proposal to repeal the ACA, including the provision allowing states to extend Medicaid to childless adults up to 138% FPL and providing enhanced federal funds for the Medicaid expansion. This brief provides estimates of changes in federal Medicaid funds and Medicaid coverage for adults covered through the ACA expansion if the expansion is eliminated starting in 2020. A repeal of the Medicaid expansion…