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

1,321 - 1,330 of 2,786 Results

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…

  • The Public’s Health Care Agenda for the 113th Congress

    Poll Finding

    As the 113th Congress is sworn in, and President Barack Obama begins his second term of office, a comprehensive new Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health survey queried the public about their priorities for, and views on, a wide range of health and health policy issues. These include issues that will preoccupy federal lawmakers, such as the role of Medicare in the deficit reduction debate, as well as issues currently being…

  • Implementation of Affordable Care Act Provisions to Improve Nursing Home Transparency, Care Quality, and Abuse Prevention

    Report

    The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement. Despite the 1987 reforms, beginning in 1997, the Government Accountability Office issued more than 20 reports documenting serious quality of care problems in nursing homes…

  • 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…

  • ¿Tengo que renovar la cobertura de Medicaid cada año?

    FAQs

    Si. Los estados generalmente comienzan el proceso enviando un aviso a cada individuo. Tenga en cuenta que el proceso de renovación puede verse diferente dependiendo de dónde viva, por lo que debe consultar el sitio web de Medicaid de su estado para ver qué requiere su proceso de renovación. Haga clic aquí para obtener una lista de sitios web y números de teléfono de cada agencia estatal de Medicaid para conocer el proceso y los…

  • Estoy cubierto por Medicaid, pero me pregunto si puedo cancelar mi Medicaid y comprar uno de los planes de salud que se ofrecen a través del mercado de seguros?

    FAQs

    Si bien puede adquirir una cobertura del mercado de seguros, si actualmente tiene cobertura de Medicaid o le han informado que cumple los requisitos para recibirla, no podrá acceder a los subsidios para las primas que hacen que la cobertura sea más asequible para las personas con ingresos más bajos. Sin los créditos fiscales del mercado, el costo de un plan probablemente sea inasequible. Medicaid ofrece una cobertura integral sin primas o con primas bajas,…

  • The Biden Administration’s Final Rule on Section 1557 Non-Discrimination Regulations Under the ACA

    Issue Brief

    This brief overviews the Biden Administration’s 2024 final rule implementing Section 1557 of the ACA, which is home to the law’s major nondiscrimination provisions. It provides a brief background on 1557 rulemaking and identifies key differences between this rule and the 2020 rule from the Trump Administration. It highlights two areas of growing interest impacted by the rule – nondiscrimination protections related to pregnancy and nondiscrimination protections for transgender people. Table 2 summarizes the major…

  • KFF Analysis Finds Physician Networks in ACA Marketplace Plans Vary Widely, and Enrollees Typically Pay More in Premiums to Access Broader Networks

    News Release

    A KFF analysis of physician networks in the Affordable Care Act’s Marketplace plans finds wide variations in the share of local practicing physicians who participate, with the least costly plans generally having a smaller share of physicians than more expensive plans. The analysis examines the breadth of physician networks listed in Marketplace plan directories in 2021 in nearly every county nationally in relation to the number of actively practicing physicians locally.  On average, Marketplace enrollees…

  • Most People Enrolled in Marketplace Coverage are Satisfied with Plan’s Premiums, Cost-Sharing and Provider Networks, New Survey Finds

    News Release

      Affordability Remains Significant Concern for Many in Non-Group Plans Following the Affordable Care Act's second open enrollment period, most people enrolled in marketplace plans report being satisfied with a wide range of their plan's coverage and features, finds a new Kaiser Family Foundation survey of people who buy their own health insurance. A large majority (74%) of those in marketplace plans rate their coverage as excellent or good, the survey finds. Most (59%) also…

  • 10 FAQs: Medicare’s Role in End-of-Life Care

    Fact Sheet

    About eight of 10 of the 2.6 million people who died in the US in 2014 were people on Medicare, making Medicare the largest insurer of health care provided during the last year of life. These Frequently Asked Questions explain Medicare’s role in or coverage of end-of-life care, advance care planning, advance directives, and hospice care. They also provide information on Medicare spending on end-of-life care, changes to the physician fee schedule, and how related issues arose…