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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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  • 10 Ways Women Could Be Affected by Repeal of the Affordable Care Act

    News Release

    Repeal of the Affordable Care Act could have a profound impact on women, as the law fundamentally changed women’s health coverage, benefits, and access to care. In a new issue brief, the Kaiser Family Foundation outlines 10 ways women could be affected if the ACA is repealed or its provisions are otherwise eliminated or modified, including through changes proposed in the House Republican replacement bill, the American Health Care Act. The brief discusses the potential…

  • Health Insurance Premiums Under the ACA vs. AHCA: County-Level Data

    News Release

    The Kaiser Family Foundation’s interactive map now allows users to compare what consumers in each county would pay in health insurance premiums after tax credits in 2020 under the Affordable Care Act vs. the House GOP replacement plan, the American Health Care Act. The maps include 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, $50,000, $75,000, or $100,000. In addition to…

  • Why Deductibles Would Rise Under the GOP Health Care Plan

    From Drew Altman

    This inaugural Drew Altman column for Axios examines how the GOP House bill would impact deductibles for people who buy insurance in the non-group market. A KFF analysis for the column shows deductibles in a typical non-group plan would be about $1550 higher under the American Health Care Act compared to the Affordable Care Act.

  • Data Note: 5 Misconceptions Surrounding the ACA

    Feature

    On the seventh anniversary of the passing of the Affordable Care Act, this Data Note highlights five of the most common misconceptions surrounding the 2010 health care law.

  • What is at Stake for Health and Health Care Disparities under ACA Repeal?

    Issue Brief

    This brief describes health and health care disparities today, highlights recent advancements in reducing disparities under the Affordable Care Act (ACA), and discusses how the American Health Care Act (AHCA) and proposed reductions in discretionary funding may affect ongoing efforts to address disparities.

  • Who Are the 7 Million Nonelderly Adults with Disabilities in Medicaid and What Would the House GOP Bill to Restructure Medicaid Financing and Repeal the Affordable Care Act Mean for Them?

    News Release

    A new brief from the Kaiser Family Foundation explains the role that Medicaid plays for nearly 7 million nonelderly adults with disabilities in the U.S. and explores what the American Health Care Act could mean for their health care and coverage. Medicaid covers more than three in 10 nonelderly adults with disabilities, including people with physical disabilities, such as cerebral palsy, multiple sclerosis, and traumatic brain or spinal cord injuries; intellectual or developmental disabilities such…

  • Restructuring Medicaid in the American Health Care Act: Five Key Considerations

    Issue Brief

    On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected…

  • Web Briefing for Journalists – Potential Changes to Health Care Access and Coverage: What’s at Stake for Women?

    Event Date:
    Event

    House Republicans’ American Health Care Act and other actions under discussion by President Donald Trump’s administration and the new Congress could profoundly affect access to health care for many women. Repeal of the Affordable Care Act, changes to its birth control coverage provision, and new state and federal abortion restrictions, along with potential funding cuts and restrictions for family planning providers, including Planned Parenthood, would significantly impact the availability and cost of women’s health care,…