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The ACA MarketplaceS

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.

The Average Marketplace Deductible Grew by About $1,000 Per Person in 2026, With More Enrollees Shifting to Higher-Deductible Plans as Enhanced Tax Credits Expired

The average Affordable Care Act (ACA) Marketplace deductible experienced the steepest increase in history—growing by 37% or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired, according to a new KFF analysis. After the enhanced tax credits ended, many Marketplace shoppers shifted toward lower-premium, higher-deductible plans.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • A Guide to the Supreme Court’s Affordable Care Act Decision

    Issue Brief

    This policy brief describes the Supreme Court's decision on the Affordable Care Act and looks ahead to the implementation of health reform now that questions about the constitutionality of the law have been resolved. Brief (.pdf)

  • State Marketplace Profiles: West Virginia

    Other Post

    Final update made on October 24, 2013 (no further updates will be made) Establishing the Marketplace On February 15, 2013, Governor Earl Ray Tomblin (D) submitted a blueprint to Secretary Sebelius for West Virginia to establish a Partnership Marketplace with plan management responsibilities.1  In the previous year, Governor Tomblin had signed SB 408 into law to establish the West Virginia Health Benefits Exchange and the state had begun exploring implementation options for a state-based marketplace.…

  • State Exchange Profiles: Ohio

    Other Post

    Final update made on March 25, 2013 (no further updates will be made) Establishing the Exchange On November 16, 2012, Governor John Kasich (R) notified federal officials that Ohio would default to a federally-facilitated exchange; however, the state would maintain regulatory control over its insurance industry.1 The Governor also indicated Ohio would maintain control over Medicaid eligibility determinations. Prior to the announcement, the Department of Insurance in collaboration with other stakeholder agencies solicited subcontractors’ assistance for…

  • State Marketplace Profiles: Illinois

    Other Post

    Final update made on October 15, 2013 (no further updates will be made) Establishing the Marketplace While Governor Pat Quinn (D) had considered establishing a state-based marketplace via executive order, he began moving in the direction of a state-federal partnership marketplace in July 2012.1 ,2  While the state has established a Partnership Marketplace, the administration still intends to transition to a fully State-based Marketplace in 2015 and will continue with the necessary planning. Illinois will be…

  • State Exchange Profiles: South Dakota

    Other Post

    Final update made on April 19, 2013 (no further updates will be made)  Establishing the Exchange On September 26, 2012, Governor Dennis Daugaard (R) announced that South Dakota would not establish an exchange.1However, the state intends to maintain regulatory authority over the health insurance market and perform the plan management function for the exchange.2 The decision to have a federally-facilitated exchange was made after an inter-agency work group and a taskforce of stakeholders and legislators explored…

  • State Exchange Profiles: Oklahoma

    Other Post

    Final update made on December 13, 2012 (no further updates will be made) Establishing the Exchange  On November 19, 2012, Governor Mary Fallin (R) announced that Oklahoma would not pursue the creation of a state-based health insurance exchange.1 Prior to the announcement, Oklahoma had established the Joint Committee on Federal Health Care Law to explore the state’s options regarding federal health reform, including exchange implementation in the state.2 The Joint Committee convened in 2011 and released final exchange…

  • State Marketplace Profiles: California

    Other Post

    Final update made on November 26, 2013 (no further updates will be made) Establishing the Marketplace On September 30, 2010, former Governor Arnold Schwarzenegger (R) signed into law two complementary bills, AB 1602 and SB 900, to establish the California Health Benefit Exchange. California was the first state in the nation to pass legislation creating a health insurance Marketplace after the enactment of federal health reform.1   Current Governor Jerry Brown (D) called a special legislative…

  • State Marketplace Profiles: Washington

    Other Post

    Final update made on November 22, 2013 (no further updates will be made) Establishing the Marketplace On May 11, 2011, Governor Christine Gregoire (D) signed SB 5445 into law establishing the Washington Health Benefit Exchange (HBE).1  Additional legislation signed by the Governor in March 2012, removed limitations on the Board’s governing authority over the Marketplace (HB 2319).2  In October 2012, the state announced that the online Marketplace would be called Washington Healthplanfinder. Structure: The legislation defines Washington’s Marketplace…

  • State Marketplace Profiles: Idaho

    Other Post

    Final update made on October 3, 2013 (no further updates will be made) Establishing the Marketplace On December 11, 2012, Governor C.L. Otter (R) announced Idaho’s commitment to the establishment of a State-based health insurance Marketplace and on March 28, 2013 signed into law legislation (HB248) creating the Idaho Health Insurance Exchange.1 2  In August 2013, the state announced that the online marketplace would be called Your Health Idaho.3  While the Governor had previously signed an Executive…

  • Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

    Issue Brief

    This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the…