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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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  • Understanding Health Insurance

    Video

    The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.

  • Flint Fallout: Water Supply Safety Now Near Top of Public’s National Health Concerns, Trailing Cancer

    News Release

    In the wake of the lead crisis affecting drinking water in Flint, Mich., the public now ranks contaminated drinking water among the most serious national health issues, trailing cancer, according to the April Kaiser Health Tracking Poll. When asked about a series of health issues facing the country, more than a third (35%) identify contaminated drinking water as “extremely serious,” behind cancer (43%) and similar to heroin abuse (35%)  and ahead of major diseases such…

  • Most Americans Say Federal and State Governments Are Not Doing Enough to Combat Prescription Painkiller and Heroin Abuse; Large Majorities Believe Wide Range of Strategies Would be Effective

    News Release

     As the White House and Congress continue to debate new funding and other actions to address the nation’s opioid epidemic, the latest Kaiser Health Tracking Poll finds that most Americans believe the federal government is not doing enough to combat the recent increases in the number of people who are addicted to prescription painkillers (66%) or heroin (62%). State governments fare no better in the public’s view, with similarly large shares saying they aren’t doing…

  • Puerto Rico: Fast Facts

    Fact Sheet

    Puerto Rico: Fast Facts provides a quick snapshot of the island's demographic, health, and economic characteristics. It also provides some information on federal Medicaid rules, infrastructure, and fiscal challenges ahead.

  • Contraceptive-Only Plans: Questions and Answers

    Perspective

    In this post on The Huffington Post, Alina Salganicoff and Laurie Sobel offer a Q&A on “contraceptive-only” plans, an approach mentioned during oral arguments in the U.S. Supreme Court case Zubik v. Burwell. In the Zubik case, a group of religiously affiliated nonprofits with religious objections to providing birth control coverage seek an exemption from the Affordable Care Act's provision requiring most plans to offer such coverage without cost-sharing.

  • How Pending Health-Related Lawsuits Could be Impacted by the Incoming Trump Administration

    Issue Brief

    This brief provides an overview of current lawsuits in health policy including preventive services, abortion care, gender affirming care, Medicare drug price negotiations, nursing home staffing rules, private coverage consumer protections, and protections and health coverage for Deferred Action for Childhood Arrivals (DACA) recipients; how they may be affected by the incoming Trump administration; and the implications of their potential outcomes.

  • Compare the Candidates on Health Care Policy

    Feature

    The side-by-side comparison tool provides a quick overview of former President Trump's and Vice President Harris' records, positions, public statements, and proposed policies on a range of key health care topics.

  • ¿Dónde puedo obtener ayuda con mi solicitud del mercado?

    FAQs

    Todos los mercados de seguros deben ofrecer programas de "Navegadores" para ayudar a los consumidores a revisar sus opciones de planes, completar su solicitud de ayuda asistencia financiera, incluyendo ayuda para solicitar Medicaid o CHIP. Los navegadores también pueden ayudar con otros procesos, por ejemplo, cuando el consumidor quiere apelar las decisiones del mercado. Los navegadores reciben su remuneración del mercado, no de los planes de salud, y deben completar la capacitación en el mercado…

  • Soy autónomo y mis ingresos varían de un año a otro. ¿Cómo solicito subsidios para las primas si no sé cuáles serán mis ingresos el próximo año?

    FAQs

    Al solicitar el subsidio para las primas, se le pedirá que calcule sus ingresos esperados para el año siguiente. Un buen punto de partida suele ser considerar sus ingresos de este año o los que declaró en su declaración de impuestos del año anterior. Sin embargo, si sus circunstancias han cambiado desde entonces, debería calcular lo mejor posible sus ingresos para el próximo año. Por ejemplo, si perdió su trabajo recientemente, podría calcular menos ingresos…

  • Affordability in the ACA Marketplace Under a Proposal Like Joe Biden’s Health Plan

    Issue Brief

    This KFF analysis finds that expanding Affordable Care Act (ACA) premium subsidies like Democratic presidential nominee Joe Biden has proposed would lower the cost of Marketplace coverage for nearly all potential enrollees, including the uninsured and others currently priced out of the Marketplace. Biden's plan would, however, increase federal spending, which we do not attempt to estimate here.