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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

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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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  • Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2017: Findings from a 50-State Survey

    Report

    This 15th annual 50-state survey provides data on Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in these policies in the past year. As discussion of repeal of the Affordable Care Act (ACA), broader changes to Medicaid, and reauthorization of CHIP unfolds, this report documents the role Medicaid and CHIP play for low-income children and families and the evolution of these programs…

  • New Interactive Map with Local Data: Estimated 2016 ACA Marketplace Enrollment by Congressional District

    News Release

    As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, a new interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January. The analysis also includes maps charting by state the total number of people enrolled under the ACA Medicaid…

  • Obamacare Debate: Where GOP Governors Stand on Repeal and Replace

    From Drew Altman

    As congress prepares to vote on repeal of the Affordable Care Act, Drew Altman discusses whether Republican governors and congressional Republicans will be at odds over key issues when it comes to repealing and replacing the law in this Wall Street Journal Think Tank column.

  • The Future of Contraceptive Coverage

    Issue Brief

    This issue brief explains the Affordable Care Act's current contraceptive coverage rule, the impact it has had on women, and the state of contraceptive coverage if the rule is eliminated or modified.

  • Kaiser Health Tracking Poll: Health Care Priorities for 2017

    Feature

    The most recent Kaiser Health Tracking Poll finds that health care is among the top issues, with the economy and jobs and immigration, Americans want President-elect Donald Trump and the next Congress to address in 2017. As Congressional lawmakers make plans for the future of the Affordable Care Act, the latest survey finds the public is divided on what they would like lawmakers to do when it comes to the 2010 health care law with…

  • Poll: Public Divided on Repealing Obamacare, But Few Want It Repealed Without Replacement Details

    News Release

    As Congress begins to work on repealing and replacing the Affordable Care Act, the latest Kaiser Health Tracking Poll finds that one in five Americans (20%) support repeal alone, while three quarters either oppose repeal altogether (47%) or want to wait to repeal the law until the replacement plan’s details are known (28%). Overall, the poll finds that nearly equal shares say that the next Congress should vote to repeal the law (49%) and that…

  • The Health Care Plan Trump Voters Really Want

    From Drew Altman

    In a New York Times op-ed, Drew Altman draws on observations from focus groups in rust belt states of people in the Affordable Care Act (ACA) marketplaces who voted for President-elect Trump and say they may not like their coverage under the ACA but could like Republican replacement plans even less.

  • Kaiser Health Policy News Index: 2016 in Review

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers better understand which health policy-related news stories Americans are following, and what the public knows about health policy issues covered in the news. This analysis examines the top health policy news stories in 2016.