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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

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Tengo 35 años y pienso que tengo más riesgo de cáncer de seno porque mi mamá lo padeció. ¿Qué servicios debe cubrir mi seguro?

    FAQs

    Debería consultar con su proveedor de atención médica si cree que tiene un mayor riesgo. La mayoría de los planes de salud deben cubrir las pruebas de detección de cáncer de mama y los servicios preventivos para mujeres, para que su proveedor evalúe si tiene antecedentes familiares que aumenten el riesgo de ciertas mutaciones genéticas asociadas con un mayor riesgo de cáncer de mama (BRCA1 y BRCA2). Si su proveedor determina que tiene un mayor…

  • Soy un nuevo inmigrante y no tengo cuenta en el banco. ¿Puede la aseguradora obligarme a abrir una para tener débito automático de los pagos?

    FAQs

    No. Las aseguradoras que ofrecen cobertura en el mercado individual o en el mercado de seguros de ACA deben proporcionar una variedad de métodos de pago y no pueden exigir que un consumidor pague mediante retiros bancarios automáticos (a veces llamados transferencias electrónicas de fondos o EFT). Las normas federales requieren que la aseguradora acepte cheques en papel, giros postales y todas las tarjetas de débito prepagadas de uso general, así como EFT. Estos métodos…

  • ¿Todos los beneficios cubiertos por los planes del mercado son los mismos? ¿Cómo puedo comparar?

    FAQs

    Aunque se requiere que todos los planes de salud del mercado cubran las diez categorías de beneficios de salud esenciales, las aseguradoras en muchos estados tienen flexibilidad para modificar la cobertura de algunos de los servicios específicos dentro de cada categoría. Cualquier modificación debe ser aprobada por el mercado antes de que se puedan ofrecer los planes. Todos los planes de salud deben proporcionar a los consumidores un Resumen de Beneficios y Cobertura (SBC). El…

  • ¿Pueden cobrarme más por mi edad?

    FAQs

    Sí, en la mayoría de los estados se puede, dentro de los límites. Las reglas federales les permiten a las aseguradoras cobrar a los adultos mayores (por ejemplo, en sus 60) hasta tres veces la prima que cobrarían a los adultos más jóvenes (por ejemplo, en sus primeros años de la década del veinte). Este límite en la clasificación de edad se aplica a todas las pólizas de seguro de salud que no sean de…

  • Poll: As States Start to Ease Coronavirus Restrictions, Few Americans Expect to Stay in Hotels or Fly This Summer, Though Most Plan to Visit a Doctor, Get a Hair Cut and Dine Out

    News Release

    Most of the Public, including Most Swing Voters, Disapprove of President Trump’s Coronavirus Response and Overall Job Performance; President Earns Higher Ratings on the Economy Even as many states start to lift restrictions on businesses and social gatherings, most Americans are expecting the coronavirus pandemic to upend their summers, with few saying they expect to stay in a hotel (32%), fly (23%), or attend a concert or sporting event (19%) during the next three months,…

  • Kaiser Health Tracking Poll: November 2016

    Feature

    The November Kaiser Health Tracking Poll, conducted one week after the 2016 presidential election, finds health care played a limited role in voters’ 2016 election decisions. While President-elect Trump and Republican lawmakers have made it clear that one of their top priorities is the repeal of the Affordable Care Act, the survey finds Americans are divided on what they want to see lawmakers do to the health care law. This survey also finds that many…

  • An Estimated 52 Million Adults Have Pre-Existing Conditions That Would Make Them Uninsurable Pre-Obamacare

    News Release

    A new Kaiser Family Foundation analysis finds that 52 million adults under 65 – or 27 percent of that population -- have pre-existing health conditions that would likely make them uninsurable if they applied for health coverage under medical underwriting practices that existed in most states before insurance regulation changes made by the Affordable Care Act. In eleven states, at least three in ten non-elderly adults would have a declinable condition, according to the analysis:…

  • The Health Care Plan Trump Voters Really Want

    From Drew Altman

    In a New York Times op-ed, Drew Altman draws on observations from focus groups in rust belt states of people in the Affordable Care Act (ACA) marketplaces who voted for President-elect Trump and say they may not like their coverage under the ACA but could like Republican replacement plans even less.