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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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  • ANALYSIS: More than Half of Uninsured People Eligible for Marketplace Insurance Could Pay Less for Health Plan than Individual Mandate Penalty

    News Release

    A new Kaiser Family Foundation analysis finds that more than half (54% or 5.9 million) of the 10.7 million people who are uninsured and eligible to purchase an Affordable Care Act marketplace plan in 2018 could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

  • Poll: Half of the Public Would Blame the Trump Administration if Fewer People Enroll in Marketplace Plans This Year, and Most See President Trump and Republicans As Responsible for the ACA‘s Future 

    News Release

    Majorities of Democrats, Independents and Republicans Would Support Allowing People Younger Than Age 65 to Buy into Medicare Half (50%) of the public would say that if fewer people sign up for marketplace plans during this year’s open enrollment, it is mainly due to the Trump Administration, and most Americans (61%) see President Trump and Republicans as responsible for the Affordable Care Act’s future, the latest Kaiser Family Foundation poll finds. While the public generally…

  • ACA Mandate Repeal May Be Less Popular Than GOP Thinks

    From Drew Altman

    In this Axios column, Drew Altman discusses how public opinion seems to flip on eliminating the individual mandate as part of the tax legislation, from for it to against, when the public considers the consequences.

  • National ACA Marketplace Signups Dipped a Modest 3.7 Percent This Year

    News Release

    Overall ACA marketplace signups for 2018 dropped by 3.7 percent compared to last year’s enrollment period, a new analysis from the Kaiser Family Foundation finds. 11,760,533 people signed up for 2018 health insurance coverage on the ACA individual marketplaces, amid steep reductions in federal funding for outreach and navigators, an enrollment period half as long, and a climate of political uncertainty surrounding the law. The federal government also terminated cost-sharing subsidy payments to insurers in…

  • Understanding Short-Term Limited Duration Health Insurance

    Issue Brief

    In late 2017, President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies. This brief provides background information on short-term policies and how they differ from ACA-compliant health plans. It also analyzes the short-term plans available through two major online brokers to assess how often they include coverage for mental health, substance abuse, prescription drugs and maternity care.

  • Poll: Public Mixed on Whether Medicaid Work Requirements Are More to Cut Spending or to Lift People Up; Most Do Not Support Lifetime Limits on Benefits

    News Release

    Ahead of the Midterms, Voters across Parties See Costs as their Top Health Care Concern At a time when the Trump Administration is encouraging state efforts to revamp their Medicaid programs through waivers, the latest Kaiser Family Foundation tracking poll finds the public splits on whether the reason behind proposals to impose work requirements on some low-income Medicaid beneficiaries is to lift people out of poverty or to reduce spending. The Centers for Medicare and…

  • Kaiser Health Tracking Poll – January 2018: The Public’s Priorities and Next Steps for the Affordable Care Act

    Feature

    With the 2018 midterm elections still about ten months away, the January Kaiser Health Tracking poll examines what issues voters most want 2018 midterm candidates to talk about during their upcoming campaigns. Health care is at the top of a group of issues but health care is less important to Republicans and among voters in battleground states. While Congress is currently debating a budget to keep the government funded beyond February 8, 2018, the poll…

  • Health Care Ranks Among Voters’ Top Issues for the 2018 Midterm Elections, But It’s a Lower Priority Among Voters in Battleground States and Districts

    News Release

    Only One in Three Know the Tax Reform Law Repeals the ACA’s Unpopular Individual Mandate Health care and the economy and jobs top voters’ list as “the most important issue” for Congressional candidates to talk about ahead of November’s midterm elections, but the lineup shifts among voters in states and districts with competitive elections, the January Kaiser Health Tracking Poll finds.  When asked how important a series of major national issues are, similar shares say…

  • Kaiser Health Tracking Poll – May 2017: The AHCA’s Proposed Changes to Health Care

    Report

    With House Republicans passing the American Health Care Act (AHCA), their plan to repeal and replace the Affordable Care Act (ACA), and the Senate currently debating the plan and discussing their own approach, the latest tracking poll finds more view the ACA favorably than view the AHCA favorably. The poll examines attitudes towards specific provisions included in the replacement plan and how the public thinks the replacement plan will affect their own health care.

  • Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

    News Release

    Public Grows More Pessimistic About How Repeal Will Affect Them Personally Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill or not pass it all, finds the latest Kaiser Health Tracking Poll. Three in 10 (31%) of the public hold favorable views of the American…