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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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  • Faces of the Medicaid Expansion: How Obtaining Medicaid Coverage Impacts Low-Income Adults

    Report

    The Affordable Care Act (ACA) seeks to fill the longstanding gap in Medicaid coverage for low-income adults by expanding eligibility to a minimum floor of 138% of the federal poverty level (FPL), or $24,344 for a family of 3 in 2012. However, the Supreme Court ruling on the ACA effectively made implementation of the Medicaid expansion a state choice. If a state does not expand Medicaid, poor uninsured adults in that state will not gain…

  • Chartpack: Kaiser Health Tracking Poll — July 2009

    Poll Finding

    This document contains the chartpack from the July Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted July 7 through July 14, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (800) and cell phone (405, including 126 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Quick Take: Medicaid: 3 Key Issues to Watch in 2013

    Fact Sheet

    2013 will be a historic year for Medicaid with the implementation of major provisions to expand coverage and streamline enrollment in the Affordable Care Act (ACA) less than a year away, a surge in activity around care delivery reforms that seek to improve care and potentially reduce costs, and the unfolding of fiscal developments at the state and federal level. Today, Medicaid provides health and long-term care coverage to more than 60 million low-income children,…

  • Abortion Coverage in Marketplace Plans, 2015

    Issue Brief

    This brief analyzes state policies and insurer coverage decisions affecting the availability of abortion coverage in 2015 insurance plans offered through the Marketplaces. It finds that abortion coverage is unavailable in a total of 31 states, 24 of which have enacted laws that ban or restrict abortion coverage in plans sold through their Marketplaces and 7 of which have no abortion coverage restrictions but also have no Marketplace plans offering it.

  • The Health-Care Enrollment Story Is in the States

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the Department of Health and Human Services.

  • Obamacare and You: If You Have Medicare…

    Fact Sheet

    This short explainer highlights some of the key information for people with Medicare about how Affordable Care Act, also known as Obamacare, may affect them.

  • Obamacare Vital Signs Not Just Numbers

    From Drew Altman

    In his latest column, Kaiser President and CEO Drew Altman discusses the focus on first year metrics, especially enrollment projections, in the ACA debate.

  • Implications of the Affordable Care Act for People With HIV Infection and the Ryan White HIV/AIDS Program: What Does the Future Hold?

    Issue Brief

    There are numerous aspects of the Affordable Care Act that will be important for people with HIV in the U.S., -- however, it is unlikely that these changes will address all the needs of people with HIV. The Ryan White HIV/AIDS Program will thus remain crucial for the provision of adequate health care to HIV-infected individuals, but it will need to change. Changes in the Ryan White Program’s role will depend largely on state decisions…

  • Obamacare y Usted: Si no tiene seguro médico

    Fact Sheet

    Obamacare ha creado nuevas maneras de tener cobertura de salud. Si usted no tiene seguro médico a través de su empleador, seguramente pueda obtenerlo a través del nuevo Mercado de los Seguros Médicos (o "intercambio") en su estado. Nuevas opciones de cobertura Llenando una única aplicación, usted aprenderá sobre sus opciones de planes médicos y los costos, y si califica para tener cobertura a través de Medicaid o para recibir un subsidio para comprar un…