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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 Will the Uninsured in Wyoming Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Wyoming, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Wyoming are eligible for Medicaid or financial assistance in…

  • Data Note: How Many People Have Nongroup Health Insurance?

    Issue Brief

    The implementation of the Affordable Care Act (ACA) has focused attention on the composition of the nongroup market: how it looked before the new regulatory provisions take effect and how it will change afterwards. There are several ways of answering this question, depending on the time period for measuring enrollment and the information source. There is substantial turnover among people with nongroup coverage, which means that the number of people covered at the beginning of…

  • How 13 Million Americans Could Lose Insurance Subsidies

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on November 19, 2014. Kaiser Family Foundation calculations of how many Americans could lose subsidies in 2016 depending on the Supreme Court’s ruling in King v. Burwell. The Supreme Court is expected to rule next year on King v. Burwell, the lawsuit in which the federal government’s authority to provide financial assistance to people who buy insurance in federally operated insurance exchanges is being challenged under a…

  • Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

    Report

    This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation's Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and…

  • New Spanish-Language Cartoon and Calculator to Help Consumers Understand Health Insurance

    News Release

    The Kaiser Family Foundation today released two new Spanish-language tools to help consumers better understand health insurance as they shop for plans during open enrollment for the Affordable Care Act’s marketplaces and in other venues. El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!, is a Spanish version of the five-minute cartoon video Health Insurance Explained – The YouToons Have It Covered, a light-hearted treatment of a difficult and important topic. It breaks down…

  • Issue Brief Looks At Experiences of People with HIV With Health Coverage Under the ACA

    News Release

    A new Kaiser Family Foundation issue brief examines the impact of the Affordable Care Act (ACA) on people with HIV in five states – California, Florida, Georgia, New York and Texas. Findings are drawn from focus groups in which participants discussed their experiences during the first year of the ACA’s major coverage expansions, with the goal of understanding the implications for individual HIV health outcomes and the nation's response to the epidemic. While many focus group…

  • Early Analysis of 14 Major Cities Finds Benchmark Silver Plan Premiums in ACA Marketplaces Estimated to Rise 10 Percent on Average in 2017

    News Release

    A Kaiser Family Foundation analysis of Affordable Care Act proposed marketplace rates finds benchmark silver plan premiums are projected to increase 10 percent in 2017 on average across 14 major metropolitan areas. Based on proposed rate filings in 13 states plus the District of Columbia where complete information is currently available, the analysis assesses how premiums for the second lowest-cost silver plan – which is the basis for enrollees’ tax credits -- would change in…

  • Two Year Trends in Medicaid and CHIP Enrollment Data: Findings from the CMS Performance Indicator Project

    Issue Brief

    This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight…