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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 In a new issue brief, the Kaiser Family Foundation outlines 10 ways women could be affected if the ACA is repealed or its provisions are otherwise eliminated or modified, including through changes proposed in the House Republican replacement bill, the American Health Care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…

  • Visualizing Health Policy: Intersection of State Abortion Policy and Clinical Practice

    News Release

    This Visualizing Health Policy infographic examines state policies related to abortion and their intersection with clinical practice. Nine of 10 reported abortions in the United States are in the first trimester. Between 2003 and 2012, the abortion rate decreased 18% among women aged 15 to 44 years. Twenty-five states have laws that restrict insurance coverage of abortion in private plans. Twenty-seven states require women seeking abortion to wait 18 hours or more before obtaining an…

  • The Affordable Care Act’s Little-Noticed Success: Cutting the Uninsured Rate

    From Drew Altman

    This column was published as a Wall Street Journal Think Tank column on October 12, 2016. U.S. Uninsured Rate is At An All-Time Low, But The Public Doesn’t Know It Donald Trump derided the Affordable Care Act in the second presidential debate as a “total disaster.” One inarguable success of the 2010 health-care law has been to drive the rate of uninsured Americans to a historic low. That sizeable shift makes it significant that a plurality of the…

  • Obamacare? Zika? Which Health Stories Americans Actually Follow

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman analyzes the Kaiser Health Policy News Index to determine which health stories in the news have broken through to the public the most in the last year. One conclusion: it wasn't the Affordable Care Act.

  • Obamacare? Zika? Which Health Stories Americans Actually Follow

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman analyzes the Kaiser Health Policy News Index to determine which health stories in the news have broken through to the public the most in the last year. One conclusion: It wasn't the Affordable Care Act.

  • JAMA Forum: Reports of Obamacare’s Demise Are Greatly Exaggerated

    Perspective

    In this post for The JAMA Forum, the Kaiser Family Foundation's Larry Levitt discusses UnitedHealth’s exit from Affordable Care Act marketplaces, the possibility of bigger premium increases in 2017, and why these challenges are unlikely to significantly affect long-term sustainability of the market and the law.

  • Amid Primary Debate about Universal Coverage, Most Democrats Now Want to Expand the Affordable Care Act, Leading to Somewhat Less Favorable Views of the Law Itself

    News Release

    Voters Rank Health Care Fourth As Issue for Presidential Candidates to Discuss With the Democratic presidential primary featuring a debate about how to get to universal health coverage in the United States, the latest Kaiser Health Tracking Poll finds most Democrats want Congress to expand the Affordable Care Act, contributing to a widening gap between unfavorable and favorable views of the health reform law. Overall the poll finds that this month 49 percent of the…

  • Clinton-Sanders Contest Fuels Democratic Support for Expanding Obamacare

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses how the debate between Hillary Clinton and Bernie Sanders about how to get to universal coverage has generated more support among Democrats for expanding the Affordable Care Act (and less support for the law as is).

  • Is There a Health Care Vote? More for Democrats and Women than Other Groups

    News Release

    About One Third of Americans Perceive Wide-Scale Effort to Limit Women’s Reproductive Health Choices and Services; Most Who Do Say the Effort is a ‘Bad Thing’ Health care is one of many issues that will be important for voters in the presidential election, particularly for Democrats and women, finds the March Kaiser Health Tracking Poll. More than a third (36%) of voters consider health care “extremely important” to their vote in this year’s presidential election,…

  • The Affordable Care Act After Six Years

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do. All previous Drew Altman columns are online.