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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • New County-Level Map Compares Premiums and Tax Credits Under Senate Health Bill and ACA

    News Release

    A new interactive map from the Kaiser Family Foundation compares county-level estimates of premiums that consumers would pay under the Affordable Care Act (ACA) in 2020 with what they’d pay under the Senate’s discussion draft, Better Care Reconciliation Act (BCRA), a replacement plan unveiled last Thursday. The maps include premium and tax credit estimates by county for current ACA marketplace enrollees at age 27, 40, or 60 with an annual income of $20,000, $30,000, $40,000,…

  • Now Available: Summary of Senate Repeal/Replace Bill in 17 Key Areas

    News Release

    An interactive tool from the Kaiser Family Foundation now includes a detailed summary of the Senate’s new discussion draft, the Better Care Reconciliation Act, a plan released Thursday to repeal and replace the Affordable Care Act (ACA). With the tool, users can compare the Senate bill to current law and the House-passed American Health Care Act in 17 key areas of health policy, including Medicaid, premium subsidies to individuals, state role, financing, women’s health, and…

  • Favorability of the Affordable Care Act Tops 50%, While Across Many Measures, Majorities Oppose the Republican Plan to Replace It

    News Release

    Three-Quarters of the Public, Including Most Republicans, View Medicaid Favorably; Most Oppose Federal Funding Cuts to States As the Senate prepares to vote on the Republican bill to repeal and replace the Affordable Care Act and cap federal Medicaid funding, a new Kaiser Family Foundation Tracking Poll finds most Americans oppose the Republican plan and many of its key provisions. A majority of Republicans, however, continue to support the Republican plan, though by a significantly…

  • Kaiser Health Tracking Poll – June 2017: ACA, Replacement Plan, and Medicaid

    Feature

    As the Senate prepares to vote on the Republican plan to repeal and replace the Affordable Care Act and limit federal Medicaid funding, a new Kaiser Family Foundation Tracking Poll finds the Affordable Care Act itself remains far more popular than the bill that would replace it. A majority of Republicans, however, continue to support the Republican plan, though by a significantly narrower margin than last month. Furthermore, the Tracking Poll finds that the most…

  • No Easy Choices: 5 Options to Respond to Per Capita Caps

    Issue Brief

    Under a per capita cap, per enrollee spending would be capped, but the total amount of federal dollars to states could vary with enrollment changes and states would not be able to impose enrollment caps. Faced with restrictions in federal financing, states would have to make hard choices. This brief outlines the key measures states could use to manage their budgets and the associated challenges under a per capita cap: raise taxes or make other…

  • The Great Medicaid Divide

    From Drew Altman

    In his Axios column, Drew Altman examines how the core views Republicans have about Medicaid differ from those of Democrats and Independents, and how those views drive the policy changes they are proposing for the program.

  • Map: Counties at Risk of Zero Insurers Offering Plans in the 2018 Marketplace

    News Release

    Ahead of the June 21 federal deadline for insurers to submit rates for healthcare.gov, the Kaiser Family Foundation has released a new map that will track counties at risk of zero insurers offering plans in the 2018 marketplace. Compiled from a Foundation analysis of insurer filings and news reports, the map charts the counties at risk of having no insurers based on current public announcements, along with the name of the 2017 participating insurer and…

  • Kaiser Family Foundation/Washington Post Partnership Survey Probes Experiences and Views of Rural Americans

    News Release

    Jobs Are Major Concern for Rural Residents: Two Thirds Rate Local Job Market as Fair or Poor, and Most Would Encourage Young People to Leave for Opportunities Elsewhere A new partnership survey of rural and small town America conducted by the Kaiser Family Foundation and The Washington Post gauges the views and experiences of people living in these communities and how they compare to those of urban and suburban residents. The survey finds that while…

  • State Data: What Has Happened to Health Coverage and Financing Under the Affordable Care Act?

    News Release

    As Congress presses forward with efforts to repeal and replace the Affordable Care Act, a new interactive map from the Kaiser Family Foundation provides a window into the changes in health insurance coverage and financing in each state under the 7-year-old law. The ACA increased enrollment in health insurance by expanding Medicaid, offering tax credits to low- and middle-income marketplace enrollees and reforming insurance market rules concerning coverage for people with pre-existing health conditions. Map…