Affordable Care Act

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 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…

  • Following Midterms, Both Democrats and Republicans Expect Washington to Continue to Debate the Affordable Care Act, But the Public Is Splintered Over What Congress Should Do

    News Release

    About Half of Uninsured Expect To Find Coverage in the Coming Months, Though Another Quarter Say They Won't Because They Do Not Believe They Can Find an Affordable Plan Following the Nov. 4 midterm elections that saw Republicans seize control of the Senate and expand their House majority, nearly half of Americans (47%) expect increased debate between the two parties over the Affordable Care Act, according to the Kaiser Family Foundation's latest tracking poll. In comparison,…

  • Kaiser Health Policy News Index: December 2014

    Feature

    Other than the big stories of Ferguson, Ebola and ISIS, the only other news which captured a majority of the public’s attention this month was President Obama’s executive order on immigration. Smaller, yet substantial, shares report closely following many health policy news stories this month. Over four in ten say they closely followed the lawsuit filed by House Republicans against President Obama over the implementation of the health care law and about a third say…

  • Proposed Medicaid Expansion in Utah

    Fact Sheet

    This fact sheet provides a summary of the proposal to expand Medicaid in Utah. This has not been officially submitted to CMS and needs state legislative approval before it could be implemented.

  • What’s the Political Power of Those Newly Insured Under Obamacare?

    News Release

      With 17 million people newly-insured since 2014, Drew Altman's latest column for The Wall Street Journal's Think Tank takes a look at whether they will make an impact in the first presidential election since Affordable Care Act enrollment began. All previous columns by Drew Altman are online.

  • Few Uninsured Know Date of Pending Deadline for Obtaining Marketplace Coverage; Many Say They Will Get Coverage Soon, Though Cost is a Concern

    News Release

    Most Democrats Like Medicare-for-All, But Very Few Say the Issue Will Drive Their Votes in the 2016 Elections Similar to Last Month, More Hold Unfavorable Views of the ACA than Favorable Ones The Affordable Care Act's third open enrollment period will end on Jan. 31, but the latest Kaiser Health Tracking Poll finds that only a small share of people without health insurance realize it. Just 7 percent of the uninsured correctly identify January as…

  • Covering the Remaining Uninsured: Not Just a Red-State Issue

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why covering the nation’s remaining uninsured population is more than just a red state issue. All previous columns by Drew Altman are available online.  

  • Updated Infographic Explains New Federal Regulations on Contraceptive Coverage

    News Release

    A newly-updated infographic from the Kaiser Family Foundation explains the final regulations on employer-based coverage of birth control released today by the U.S. Department of Health & Human Services. How Does Where You Work Affect Your Contraceptive Coverage? provides a clear explanation of coverage requirements under the new regulations for employers with religious objections to contraceptive coverage, including houses of worship, religiously-affiliated nonprofits and closely-held for-profit corporations. A related summary, also updated to reflect the new regulations,…

  • Takeaways From Alaska’s Medicaid Expansion

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses the implications of the governor of Alaska’s decision to move ahead unilaterally with Medicaid expansion. All previous columns by Drew Altman are available.