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Affordable Care Act

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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  • Poll: Large Majority of the Public, Including Half of Republicans and Trump Supporters, Say the Administration Should Try to Make the Affordable Care Act Work

    News Release

    Most Republicans Are “Disappointed” But Not “Angry” That Repeal-and-Replace Legislation Did Not Pass Senate After the Senate’s failure to pass legislation to repeal and replace the Affordable Care Act, the latest Kaiser Health Tracking Poll finds that eight in 10 Americans (78%) say President Trump and his administration should do what they can to make the current health care law work. This includes large majorities of Democrats (95%) and independents (80%), as well as about…

  • Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

    Issue Brief

    While the future of legislation to repeal and replace the Affordable Care Act (ACA) and make fundamental changes to the structure and funding of the Medicaid program is uncertain, states and the Administration may achieve major changes to Medicaid through the use of Section 1115 Medicaid waivers. Wisconsin submitted a waiver amendment request to CMS in June 2017 and Maine submitted a waiver application to CMS in August 2017. Unlike previous waivers that encompass the…

  • Gaps in Coverage Among People With Pre-Existing Conditions

    Issue Brief

    The American Health Care Act (AHCA), which has passed the House of Representatives, contains a controversial provision that would allow states to waive community rating in the individual insurance market. In this brief we estimate the number of people with pre-existing conditions who might be affected by such a policy.

  • How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare

    Issue Brief

    This brief explains the key AHCA provisions that would reshape the private market to more closely resemble the pre-Affordable Care Act period, and the effects of these changes on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

  • Kaiser Health Tracking Poll – September 2017: What’s Next for Health Care?

    Feature

    This poll finds large majorities across all parties say reauthorizing funding for the Children's Health Insurance Program (CHIP) is an important priority for Congress; however, a larger share of Republicans also say it is important for Congress to work on repealing and replacing the Affordable Care Act (also known as Obamacare). This month's Kaiser Health Tracking Poll also examines public support for a variety of competing health care policies aimed at improving or replacing the…

  • Five Ways the Graham-Cassidy Proposal Would Affect Women

    Fact Sheet

    The Graham-Cassidy Senate proposal to repeal and replace the Affordable Care Act that could have a far-reaching impact on women's health care access and coverage. A new fact sheet outlines the ways women could be affected.

  • Kaiser Health Tracking Poll: August 2013

    Feature

    As outreach efforts for enrollment in the health insurance marketplaces created by the Affordable Care Act (ACA) increase over the summer, the August Kaiser Health Tracking Poll finds that the public’s most trusted sources of information on the law are not necessarily the ones people are most likely to be hearing from.

  • Translating The Medicaid Expansion Into Increased Coverage: The Role Of Application Assistance

    Event Date:
    Event

    Under the Affordable Care Act (ACA), beginning in 2014 all states will employ streamlined, technology-driven enrollment systems to help eligible people sign up for insurance affordability programs, including Medicaid, the Children's Health Insurance Program and the new health insurance exchange marketplaces. Even with these streamlined systems in place, application assistance will be important for helping to translate the ACA's Medicaid and other coverage expansions into increased coverage. The Kaiser Family Foundation's Commission on Medicaid and…

  • Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

    Issue Brief

    This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the…