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The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

About the ACA

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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 Analysis In Eleven States Finds Modest Increases For ACA Silver Plans

    News Release

    A Kaiser Family Foundation analysis of Affordable Care Act (ACA) plans in major metropolitan areas in 11 states where data are available, including the District of Columbia, finds that preliminary 2016 premiums for benchmark silver plans grew modestly, but increased more sharply this year than last year. The average increase for benchmark plans across the cities is 4.4 percent for 2016 compared with a 2 percent increase nationwide in 2015.

  • Renewals in Medicaid and CHIP: Implementation of Streamlined ACA Policies and the Potential Role of Managed Care Plans

    Issue Brief

    This brief reviews the new renewal requirements for Medicaid and CHIP that are designed to maintain continuity of coverage for eligible individuals. It provides an overview of state implementation of the new renewal policies and considers the potential role managed care plans can play in supporting renewals. Key findings include: some aspects of the simplified renewal policies have not yet been fully implemented due to a range of challenges; some states, including Washington and Rhode…

  • Poll Finds 62% of Americans Approve of the Supreme Court’s Decision to Continue Allowing ACA Health Insurance Subsidies in All States, While 32% Disapprove

    News Release

    Public’s View of the Health Care Law Remains Nearly Evenly Divided Immediately Following King v. Burwell Ruling Nearly Eight in 10 Americans Expect More Major Battles about the ACA in the Future Just over six in 10 Americans (62%) say they approve of the U.S. Supreme Court’s decision last week to continue allowing low- and moderate-income people in all states to be eligible for government subsidies to buy health plans through Affordable Care Act (ACA)…

  • 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…

  • State Flexibility to Address Health Insurance Challenges under the American Health Care Act, H.R. 1628

    Issue Brief

    The American Health Care Act (AHCA), a bill passed by the House in May 2017 to repeal and replace the Affordable Care Act (ACA), would present states with new authority in individual insurance markets, along with a number of difficult problems and choices and limited resources with which to address them. States would be able to obtain waivers and would be eligible for $123 billion in grant funds, including money from a new Patient and…

  • What’s Really At Stake In the Medicaid Spending Debate

    From Drew Altman

    In this Axios column, Drew Altman highlights that the federal debate about the American Health Care Act’s Medicaid spending reductions will ultimately be a debate about every state’s general budget spending priorities, as states discuss whether to offset reductions in federal revenues with some combination of cuts to their Medicaid programs, increased taxes, and cuts to spending in other areas.

  • Factors Affecting States’ Ability to Respond to Federal Medicaid Cuts and Caps: Which States Are Most At Risk?

    Issue Brief

    This issue brief examines the factors that could affect states’ ability to cope with reductions in federal Medicaid funding of the sort proposed in the House-passed American Health Care Act (AHCA), which would eliminate enhanced federal matching funds for the Affordable Care Act’s Medicaid expansion and convert Medicaid to a per capita cap or block grant system of financing.

  • Map: Counties at Risk of Zero Insurers Offering Plans in the 2018 Marketplace

    News Release

    Ahead of the June 21 federal deadline for insurers to submit rates for healthcare.gov, the Kaiser Family Foundation has released a new map that will track counties at risk of zero insurers offering plans in the 2018 marketplace. Compiled from a Foundation analysis of insurer filings and news reports, the map charts the counties at risk of having no insurers based on current public announcements, along with the name of the 2017 participating insurer and…