Home Affordable Care Act Topics

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?

Latest News

More KFF Health News

Stay informed.

Get KFF's latest on the Affordable Care Act

Stay informed.

Get KFF's
latest on the Affordable
Care Act

View the Latest: Affordable Care Act

Filter

List Grid

1,311 - 1,320 of 2,786 Results

  • Polling Data Note: Beyond the ACA, the Affordability of Insurance Has Been Deteriorating Since 2015

    News Release

    The debate about the future of the Affordable Care Act and its individual insurance marketplaces may be taking the focus off the affordability challenges facing the broader population, most of whom get their health coverage through employers, Medicare or Medicaid. New survey findings from the Kaiser Family Foundation show that health care has become somewhat less affordable even among those with health insurance. Since 2015, larger shares of people with health insurance say they have…

  • KFF Analysis: Average Health Insurance Tax Credit for Consumers Would Be at Least a Third Lower Under Currently Discussed Replacement Plans than the ACA

    News Release

    A new analysis from the Kaiser Family Foundation estimates that the average health insurance premium tax credit received by consumers in 2020 would be at least 36 percent lower under replacement proposals being discussed by Republicans in Congress than under the Affordable Care Act. The average tax credit also would increase more slowly under replacement proposals, the analysis finds: In the House Discussion Draft alternative to the ACA, which has been recently discussed in media…

  • Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid

    Feature

    This month’s Kaiser Health Tracking Poll explores the public’s views on the changing landscape of the U.S. health care system including proposals to repeal and replace the Affordable Care Act (ACA) and to change Medicaid financing to a system of block grants or per capita allotments. The survey also examines which sources, including news media and other sources, the public trusts for information on the proposed changes to the country’s health care system.

  • Amid Repeal Debate, Public Views Obamacare More Favorably Than Unfavorably

    News Release

    Large Majorities Want to Continue Federal Funding for Medicaid Expansion; Two Thirds Favor Current Federal Role over Block Grants or Per-Capita Caps As President Trump and Congress weigh repealing the Affordable Care Act, the latest Kaiser Health Tracking Poll finds more Americans viewing the law favorably than unfavorably (48% compared to 42%). This is the highest level of favorability measured in more than 60 Kaiser Health Tracking Polls conducted since 2010. The shift largely reflects…

  • Data Note: Variation in Per Enrollee Medicaid Spending Across States

    Issue Brief

    Proposals to transition Medicaid a block grant or per capita cap would reduce federal spending. To understand per capita cap proposals, it is helpful to understand variation in per enrollee spending and per enrollee spending growth across states and enrollment groups. A per capita cap policy could lock in historic variation. This data note uses interactive maps and tables to show variation in per enrollee spending and spending growth by state and eligibility group.

  • High-Risk Pools For Uninsurable Individuals

    Issue Brief

    For more than 35 years, many states operated high-risk pool programs to offer non-group health coverage to uninsurable residents. The federal government also operated a temporary high-risk pool program established under the Affordable Care Act (ACA) to provide coverage to people with pre-existing conditions in advance of when broader insurance market changes took effect in 2014. This issue brief reviews the history of these programs to provide context for some of the potential benefits and…

  • In Focus: Listening to Enrollees with Affordable Care Act Coverage Who Voted for Trump

    News Release

    As Republicans in Washington pursue efforts to repeal and replace the Affordable Care Act, what do enrollees in ACA marketplaces and state Medicaid expansions who voted for President Trump want in a health care plan? The Kaiser Family Foundation asked some of them in six focus groups convened in December in Michigan, Ohio, and Pennsylvania -- three with Trump voters enrolled in the ACA marketplaces and three with Trump voters in Medicaid. Focus group participants…

  • Listening to Trump Voters with ACA Coverage: What They Want in a Health Care Plan

    Issue Brief

    President Donald Trump and Republicans in Congress are moving to follow through on their campaign promise to repeal and replace the Affordable Care Act (ACA). To gain a better understanding of the personal experiences of Trump voters with health coverage provided through the ACA and the changes they hope to see in the health system moving forward, the Kaiser Family Foundation (KFF) held focus groups in December 2016 with Trump voters in cities in three…

  • Compare Key Elements of ACA Repeal and Replace Proposals with New Interactive Tool

    News Release

    President Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act. A new interactive tool from the Kaiser Family Foundation enables users to create side-by-side comparisons of major ACA alternative plans, now including 2017 proposals from Sen. Rand Paul and from Sen. Bill Cassidy. With the tool, users can compare the plans’ approaches to more than a dozen key areas of health policy, including individual insurance market rules, requirements and…