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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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  • The Role Of Health Care In The 2020 Election

    Interactive

    This interactive map highlights what voters from the 2020 general election and Democratic primary voters said about health care as they vote, based on KFF's analysis of the state-level AP VoteCast data collected in most states. The primary election data also includes state-specific charts highlighting where health care ranks as issue, views about a single-payer health plan and a public option, and other health care findings from the AP VoteCast data with key demographic breakouts.

  • 2021 Calculator – Before COVID-19 Relief

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2021 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • Navigator Funding Restored in Federal Marketplace States for 2022

    Issue Brief

    This data notereviews the data from CMS about its funding awards to Navigator programs serving consumers in the federal marketplace states during the 2022 open enrollment season, as well as funding trends over time and funding by state.

  • Ten Changes to Watch in Open Enrollment 2022

    Issue Brief

    Even as the ninth annual Open Enrollment period gets underway, the Affordable Care Act (ACA) Marketplaces continue to evolve and important changes are expected. This issue brief discusses what changes to watch out for in the coming enrollment period.

  • 2021 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2021 premium data and to reflect subsidies in the American Rescue Plan Act of 2021, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on…

  • 2021 Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: Esta calculadora ha sido actualizada con los cambios a los subsidios en el American Rescue Plan Act de 2021 (el acta de alivio por COVID-19). Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act,…

  • Expanding Medicare to Adults at Age 60 Years—Medicare-for-More?

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt examines the implications of lowering Medicare’s age of eligibility, which is emerging as a potential pathway toward Medicare-for-all or a public option among single-payer advocates. He explores the implications for costs, industry, people and broader reform efforts.

  • 2022 Survey of ACA Marketplace Assister Programs and Brokers

    Report

    This survey of Marketplace assister programs and brokers tracks the experiences of professionals signing people up for Affordable Care Act coverage. It also examines the role that these programs expect to play when the COVID-19 public health emergency (PHE) ends, potentially ending Medicaid eligibility for millions of Medicaid enrollees.

  • 10 Years of Hospital Readmissions Penalties

    Feature

    Over the 10-year lifetime of a Medicare program aimed at reducing hospital readmissions, 93% of eligible hospitals have been penalized at least once. Hospital readmissions have become less frequent, and most experts attribute that partly to the financial threat of the penalties, though other factors likely contributed to the improvements.