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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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  • The ACA and People with HIV: Profiles from the Field

    News Release

    New in-depth profiles of 12 people with HIV highlight how the Affordable Care Act’s coverage expansions impacted their access to coverage and care. While some experienced serious bumps along the way, those who gained coverage through Medicaid and the Marketplaces were largely able to meet both their HIV and non-HIV care needs. At the same time, the Ryan White HIV/AIDS Program continued to play a role in HIV care and coverage, both for those who remained…

  • Poll Finds Nearly Three Quarters of Americans Say Prescription Drug Costs Are Unreasonable, and Most Blame Drug Makers Rather Than Insurers for the Problem

    News Release

    If Supreme Court's King v. Burwell Decision Restricts Insurance Subsidies to Certain States, Most Say Congress Should Act to Ensure Residents of All States are Eligible, and a Majority in Potentially Affected States say Their State Should Act Public's Views on Affordable Care Act Are Divided and Unchanged: 42% Unfavorable and 39% Favorable Nearly three quarters (73%) of the public view prescription drug costs as unreasonable, and far more blame pharmaceutical companies more than insurers…

  • What a Break in the Obamacare Battles Could Bring

    From Drew Altman

    Following the Supreme Court’s King v. Burwell decision, the Affordable Care Act could use a break from the intense political heat, though it may not get a long one as the 2016 election season heats up and presidential candidates play to their bases on health care, writes Drew Altman in his latest column for The Wall Street Journal’s Think Tank.

  • Poll: On Health Care, Democrats and Democratic-Leaning Independents Trust Sen. Sanders the Most, but Significantly More People Support a Public Option than Medicare-for-All

    News Release

    3 in 4 Americans Do Not Expect Congress to Take Action to Lower Drug Costs Before the 2020 Election Ahead of tonight’s Democratic presidential debate, Sen. Bernie Sanders is the candidate most trusted on health care by Democrats and Democratic-leaning independents, though the Medicare-for-all plan he has championed is significantly less popular than the “public option” approach put forward by some other candidates, the latest KFF Health Tracking Poll finds. Among the overall public, a…

  • Data Note: Prescription Drugs and Older Adults

    Issue Brief

    This data note explores the attitudes and experiences of older adults, ages 65 and up, when it comes to prescription drugs and related policy proposals being discussed. Experiences across different demographic groups are explored, such as household income and health status.

  • The Average Marketplace Deductible Grew by About $1,000 Per Person in 2026, With More Enrollees Shifting to Higher-Deductible Plans as Enhanced Tax Credits Expired

    News Release

    The average Affordable Care Act (ACA) Marketplace deductible experienced the steepest increase in history—growing by 37% or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired, according to a new KFF analysis. After the enhanced tax credits ended, many Marketplace shoppers shifted toward lower-premium, higher-deductible plans.

  • In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

    News Release

    ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

  • How Unaffordable is Health Care? 

    Video

    Health care affordability is a top issue for many people. Why and how did care get so expensive? In this three-part video series, KFF experts look at the rising cost of health care in the U.S. from the macro level to the issues facing everyday Americans. Drawing on KFF policy analysis and polling, the videos examine the underlying drivers of health care spending, the true cost of employer sponsored health insurance and whether the Affordable…

  • Eight Trends Shaping 2026 Health Care Costs

    Other Post

    A new Peterson-KFF policy explainer lays out the health care trends shaping the 2026 policy debates, including rising premiums, spending on prescription drugs, health care price transparency and consolidation, artificial intelligence in health care, Medicaid funding cuts and other key program changes.