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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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  • How Small Business Owners Get Health Insurance

    Perspective

    As with any economic policy issue, there has been much discussion of how the Affordable Care Act (ACA) will affect small businesses. But, there’s been very little focus on how the health reform law will affect the owners of those businesses as people. As our recently released Employer Health Benefits Survey shows, small businesses are much less likely than larger businesses to offer health benefits to their workers. Half of businesses with 3-9 workers and…

  • Data Note: A Snapshot of Public Opinion on the Individual Mandate

    Poll Finding

    For the two years since the law's passage, and during the debate leading up to it, the individual mandate has been one of the most controversial aspects of the law. As the lawyers, policy makers, ACA opponents and supporters focus intently on the Supreme Court hearings, this Data Note looks at what the general public thinks of the mandate, explores the reasons why favorability ratings have been so low, and suggests that while opinion on…

  • Americans Remain Divided on Health Reform But Are Confused About The Law And How And When It Will Affect Them

    News Release

    Many Provisions That Take Effect in 2010 Are Popular and Have Bipartisan Support Cable News Tops List of the Public’s “Most Important” Information Sources MENLO PARK, Calif. –The first Kaiser Health Tracking Poll fielded since the passage of health reform last month finds that 8 in 10 Americans know that President Obama signed the legislation  into law.  But 55 percent say they are confused about the law and more than half (56%) say they don’t yet have…

  • The ACA and Fluoridation: The Power of Political Symbols

    Perspective

    In the 1950s, water fluoridation became a public health controversy that morphed into a symbolic issue of larger proportions. For its opponents, fluoridation came to symbolize big government and even for some, a communist threat. The controversy became so odd that it was parodied in Stanley Kubrick’s 1964 film “Dr. Strangelove,” in which General Jack Ripper starts a nuclear war to stop a communist plot to “sap and impurify all of our precious bodily fluids”…

  • Majority Want No Spending Cuts to Education, Medicare or Social Security

    Feature

    Majority Want No Spending Cuts to Education, Medicare or Social Security Download Source Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health, The Public’s Health Care Agenda for the 113th Congress (conducted January 3-9, 2013)

  • Republican Voters Have Moved On from Hating the ACA

    From Drew Altman

    In this Axios column, Drew Altman analyzes KFF’s tracking poll and shows that the ACA is now yesterday’s issue for Republicans. They have shifted their sights to Medicare-for-all...at least for this election season.