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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • Medicare-for-All vs. Single Payer: The Impact of Labels

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, “Medicare-for-All vs. Single Payer: The Impact of Labels”, Drew Altman uses new polling on a Medicare-for-all or single payer health system to explain how what you call a health reform plan can substantially affect the public’s response. All previous Drew Altman columns are online.

  • Medicare-for-All vs. Single Payer: The Impact of Labels

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, "Medicare-for-All vs. Single Payer: The Impact of Labels", Drew Altman uses new polling on a Medicare-for-all or single payer health system to explain how what you call a health reform plan can substantially affect the public's response.

  • Public Split On What to Do About the Health Care System, Though More Support Building on ACA Than Repealing It, Replacing with a GOP Alternative, or Creating a Single Payer Plan

    News Release

    Following Flint Water Crisis, Nearly Half Worry about Their Community's Water Supply Almost Half of Public is Concerned about a Widespread Zika Outbreak in U.S. This Year The latest Kaiser Health Tracking Poll finds the public as divided as the remaining presidential candidates over their vision for the future of the nation's health care system. When asked to choose among four broad approaches for changing the health care system currently being discussed, the largest share…

  • Kaiser Health Tracking Poll: February 2016

    Feature

    The February Kaiser Health Tracking Poll finds Americans are divided on possible changes to the current health care system with 36 percent of Americans saying policymakers should build on the existing law to improve affordability and access to care, 16 percent saying they would like to see the health care law repealed and not replaced, 13 percent saying the current law should be repealed and replaced with a Republican-sponsored alternative, and 24 percent saying the…

  • Behind the Challenges to Universal Health Coverage

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses why political reality and the diverse makeup of the remaining uninsured population mean that the likeliest path to universal coverage is a multi-step approach.

  • Key Data on Health and Health Coverage in South Carolina

    Fact Sheet

    This fact sheet draws on data from “Health and Health Coverage in the South: A Data Update” to highlight findings for South Carolina. The findings show the current status of health and health coverage in the state and the potential coverage gains that may be achieved through the Affordable Care Act.

  • Health and Health Coverage in the South: A Data Update

    Issue Brief

    This brief provides key data on the South and the current status of health and health coverage in the South to provide greater insight into the health needs in the region and the potential coverage gains that may be achieved through the ACA. It includes data on the uninsured, Medicaid expansion and eligibility for coverage.

  • What New Data Tell Us About Doctor Choice

    News Release

    Is choice of doctors eroding? Drew Altman explores the rhetoric versus reality and why the issue resonates with Americans, in his latest column for The Wall Street Journal's Think Tank. All previous columns by Drew Altman are online.