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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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  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

  • What Would Another Trump Presidency Mean for Health Care?

    Perspective

    In a new column in JAMA Health Forum, Larry Levitt, KFF’s executive vice president for health policy, explores what a second Trump presidency might mean for health policy based on his record and remarks, including potentially weakening the Affordable Care Act, reducing federal Medicaid costs, and restricting access to abortion.

  • I notice something called “Easy pricing” under the plan name on HealthCare.gov. What does that mean?

    FAQs

    "Easy pricing" refers to a "standardized" plan design on HealthCare.gov that aims to make it simpler to compare plans by applying the same to each category of essential health benefits across all easy pricing plans in the same metal level. For example, all Bronze-level easy pricing plans have the same deductible and copays. By contrast, non-standardized Bronze-level plans might have different deductible and copay amounts. Easy pricing plans are marked with a green circle with…

  • Tuve seguro médico el año pasado a través de un plan del mercado de seguros de salud y también recibí créditos fiscales anticipados para reducir mi prima mensual. Dado que el mercado ya determinó que yo...

    FAQs

    Sí. Debe presentar una declaración de impuestos federal para cualquier año en el que haya recibido un crédito fiscal para la prima. Cuando presente la declaración, tendrá que calcular para cuánto crédito fiscal era realmente elegible ese año. La determinación del mercado de seguros de salud que recibió el año pasado se basó en su estimación de buena fe de cuál sería su ingreso anual. Cuando presente su declaración de impuestos, informará sus ingresos reales.…

  • ¿Me pueden cobrar primas más altas en el mercado de seguros de salud si fumo?

    FAQs

    En la mayoría de los estados, sí. Generalmente, una aseguradora puede cobrar hasta un 50% más a una persona que consume productos de tabaco. Por ejemplo, si la prima para alguien de su edad (antes de que se apliquen los créditos fiscales) fuera de $200 por mes, si usted es consumidor de tabaco, su prima podría aumentar a $300 por mes. Algunos estados prohíben a las aseguradoras aplicar un recargo por tabaco: California, Connecticut, Distrito…

  • 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…

  • About 5 Million Uninsured People Could Get ACA Marketplace Coverage Without a Monthly Premium – But They Would Have to Enroll Soon

    News Release

    About 5 million uninsured people across the country could get coverage through an Affordable Care Act Marketplace health plan with virtually no monthly premium if they enroll soon, a new KFF analysis finds. In most states, open enrollment runs through January 15, with tax credits available to help eligible low- and middle-income people afford coverage. Those tax credits would offset the full monthly premium for the lowest cost plan or plans for millions of uninsured…

  • Signing Up for Marketplace Coverage Remains a Challenge for Many Consumers

    Policy Watch

    As open enrollment begins for Marketplace plans, this Policy Watch provides information about consumer experiences with Marketplace sign up from the 2023 KFF Consumer Survey. Data from the survey show that Marketplace sign up has been a challenge to many consumers---often more complicated than enrollment in other kinds of health insurance. The Policy Watch also spotlights efforts to address common enrollment problems such as option overload and transitioning to Marketplace coverage from other forms of…