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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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  • How Does the Benefit Value of Medicare Compare to the Benefit Value of Typical Large Employer Plans?: A 2012 Update

    Issue Brief

    This study compares the value of Medicare's fee-for-service benefits last year with the value of benefits in two large employer health plans -- a large health plan serving federal employees and a typical large employer Preferred Provider Organization (PPO) plan. For individuals ages 65 and older, the study finds that Medicare remains less generous on average than typical large employer health plans, even after recent improvements in the program's drug coverage. Overall, Medicare would cover…

  • Medicare Now and in the Future

    Issue Brief

    Download PDF Issue Medicare is a valuable source of health insurance for nearly 45 million Americans – mainly seniors ages 65 and older, but also 7 million younger adults with permanent disabilities.  Before Medicare was signed into law in 1965, about half of all seniors lacked hospital insurance.  Today, virtually all people ages 65 and over are covered by Medicare.  Medicare is a popular program, but faces a number of issues and challenges in the…

  • Kaiser Health Tracking Poll — November 2009

    Poll Finding

    The November Kaiser Health Tracking Poll shows little movement in measures of public opinion about health reform from recent months. Among the new findings is a ranking of the public's top priorities from among a list of elements of the legislation. There were both similarities and differences in priorities across partisan groups: while assuring the availability of affordable plans ranked in the top three priorities for Democrats, Republicans and independents, deficit neutrality ranked in the…

  • Policy and Political Implications of the Supreme Court Case on the Affordable Care Act

    Event Date:
    Event

    This webcast features a Kaiser Family Foundation briefing held on March 14, 2012, examining the policy and political implications of the pending U.S. Supreme Court case on the Affordable Care Act (ACA). At the briefing, the Foundation released new polling data on the public’s views about the case as well as their more general views about the health reform law. Participants included: Kaiser President and CEO Drew Altman (moderator)Joe Onek, Principal, The Raben Group Sheila…

  • Health Care in the 2008 Presidential Primaries

    Poll Finding

    This analysis find that the sharply contrasting health care platforms of the leading Democratic and Republican presidential candidates reflect dramatic differences in the perspectives of their primary voters. The article analyzes a newly released Kaiser/Harvard survey of likely primary voters in 35 states (and the District of Columbia) with January or February primaries or caucuses, as well as data from 10 other recent surveys by national media polling organizations. The article, "Health Care in the…

  • Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

    Fact Sheet

    This fact sheet provides an overview of provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which was signed into law in February 2009. The Act extends and expands the State Children's Health Insurance Program (now referred to as CHIP, not SCHIP) that was enacted with bipartisan support a decade ago as part of the Balanced Budget Act of 1997 (BBA). Fact Sheet (.pdf) Fact Sheet: State Adoption of Coverage and Enrollment…

  • Full Steam Ahead: Implementation Opportunities and Challenges for Employers and Consumers

    Event Date:
    Event

    The new health reform law will significantly affect the way employers provide health coverage to their employees, and will transform many of the choices and protections consumers have in the marketplace. This briefing explored the major provisions in the law that relate to these changes. This September 8 briefing was cosponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation. For more information, please visit Alliance's event page. Full Video   Speakers…

  • Pulling it Together: What Conservatives Are Winning

    Perspective

    Conservatives are out of sorts these days about the direction in which health care is headed. They think the new health reform law expands the role of government too much and spends too much at a time when they believe deficit reduction should be a higher priority. The claims about death panels and a government takeover of the health system aside, these are principled positions for conservatives to take – they are supposed to be…

  • Coping with Fragmented Payment in the Real World

    Event Date:
    Event

    The Alliance for Health Reform and The Commonwealth Fund sponsored this briefing which focused on three communities that have reformed and harmonized health care payments across payers to improve care: a New York health center that serves a low income population; a Colorado community that pools money from public and private sources to provide care for all patients; and the State of Maryland, which has been using an all payer hospital rate setting system for…

  • Patient Cost-Sharing Under the Affordable Care Act

    Report

    Under the Affordable Care Act (ACA), four tiers of health insurance will be offered in the health insurance exchanges and throughout the individual and small group markets beginning in 2014. Under the minimum coverage plan, the “Bronze” plan, the insurance plan will pay for 60 percent of the costs of covered benefits on average while the individual enrolled will pay the remaining 40 percent in deductibles, copays and coinsurance. Individuals will have the option to…