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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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  • Early 2017 Financial Data Indicate Stabilizing Individual Insurance Market

    News Release

    Insurer financial data through the first quarter of 2017 suggest the individual market has been stabilizing and insurers in this market are regaining profitability, finds a new analysis from the Kaiser Family Foundation. The analysis tracks insurer financial performance, starting before the launch of Affordable Care Act marketplaces, through two indicators: Medical loss ratios (the share of health premiums paid out as claims) and average gross margin per member per month (the average amount by which…

  • Public Wants Republicans to Work with Democrats on Health Care

    From Drew Altman

    In this column for Axios, Drew Altman discusses a new poll finding showing substantial support for Republicans to drop repeal and work with Democrats on improving the Affordable Care Act, from the general public, Trump supporters, and Republicans.

  • Kaiser Health Tracking Poll – July 2017: What’s Next for Republican ACA Repeal and Replacement Plan Efforts?

    Feature

    As the U.S. Senate continues to debate their plan to repeal and replace the ACA, the latest Kaiser Family Foundation tracking poll finds the public souring on the effort with a growing majority opposed to the plan and a large share that say the plan does not fulfill most of the promises President Trump has made about health care. Even among Republicans, the poll finds that about half would be “less likely” to support the…

  • Growing Majority of Americans Oppose Congress’ Plan to Repeal and Replace the Affordable Care Act

    News Release

    Intensity Gap: Democrats are Twice as Enthusiastic about the ACA than Republicans are About Its Replacement Two-Thirds of Public Oppose Major Medicaid Cuts as Part of Repeal and Replace Plan As the U.S. Senate continues to debate their plan to repeal and replace the 2010 Affordable Care Act, the latest Kaiser Family Foundation tracking poll finds the public souring on the effort with a growing majority opposed to the plan. This month’s poll finds 61…

  • Kaiser Health Tracking Poll: July 2016

    Feature

    In advance of the Democratic and Republican National Conventions, the July Kaiser Health Tracking Poll examines the role that health care may play in the 2016 presidential election: how important health care is to voters, what health care issues voters would most like to hear the candidates discuss, and which party and candidates voters feel most closely aligned with on health care issues.

  • Summary of HHS’s Final Rule on Nondiscrimination in Health Programs and Activities

    Issue Brief

    On May 18, 2016, the Department of Health and Human Services (HHS) published a final rule to implement Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health coverage and care based on race, color, national origin, age or disability, and, for the first time sex. This Issue Brief provides a technical summary of Section 1557 and the final rule and highlights new protections and provisions included in the law and rule.…

  • On Health Care Issues, Voters Give Hillary Clinton a Substantial Edge Over Donald Trump  

    News Release

    Most Americans Worry about Large Number of Zika Cases in U.S. Over Next Year While the public tilts narrowly toward unfavorable views of the Affordable Care Act, presumptive Democratic nominee Hillary Clinton holds a clear advantage on health care issues over presumptive Republican nominee Donald Trump as the 2016 national political conventions approach, and voters generally, including independents, favor Democrats on health issues, the latest Kaiser Health Tracking Poll finds. When asked which of the…