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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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  • Briefing on the ACA in CA: Year One & Beyond

    Event Date:
    Event

    Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation examined ACA implementation in California (CA) at a Sacramento, Calif. briefing and panel discussion on May 28. A state official, experts and advocates discussed issues and challenges related to implementation of the law, and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state…

  • Access to Care for the Insured and Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Issue Brief

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report,…

  • 2019 Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: esta calculadora refleja las primas para 2019. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • Medicare-for-All’s Popularity May Have Peaked

    From Drew Altman

    In this Axios column, Drew Altman looks at the polling trend on support for Medicare-for-all suggesting it may have crested as criticism has mounted. He considers what it means for the Democratic primary and continued debate for Medicare-for-all and other expansion proposals.

  • Affordable Care Act Premiums Are Falling in Many Areas of the U.S. in 2020, But Changes Vary Widely By County and Type of Plan, County-Level Analysis Shows 

    News Release

    Although premiums for Affordable Care Act Marketplace benchmark silver plans are decreasing on average across the U.S. in 2020, changes vary widely by geographic location and plan type, including premium increases in a number of counties and plans, according to a new KFF analysis of county-level data. The analysis of premium data from insurer rate filings to state regulators, state exchange websites and healthcare.gov shows how premiums are changing next year at the county level,…

  • Lifetime experience of IPV among women

    HIV, Intimate Partner Violence (IPV), and Women: An Emerging Policy Landscape

    Issue Brief

    Intimate partner violence has been shown to be associated with increased risk for HIV among women, as well as poorer treatment outcomes for those already diagnosed. This brief reviews the link between IPV and HIV, key policy changes and initiatives that attempt to address these challenges.

  • Sexually Transmitted Infections (STIs): An Overview, Payment, and Coverage

    Fact Sheet

    More people have health insurance than ever before under the Affordable Care Act (ACA), which emphasizes preventive care, including no-cost HIV and STI counseling and screening for recommended populations. This fact sheet examines trends and disparities in STI prevalence, reviews the STI screening and preventive care coverage policies for private insurance and public programs, and discusses coverage gaps and confidentiality concerns in the provision of these services.

  • The Role Of Health Care In The 2020 Election

    Interactive

    This interactive map highlights what voters from the 2020 general election and Democratic primary voters said about health care as they vote, based on KFF's analysis of the state-level AP VoteCast data collected in most states. The primary election data also includes state-specific charts highlighting where health care ranks as issue, views about a single-payer health plan and a public option, and other health care findings from the AP VoteCast data with key demographic breakouts.

  • Surprise Bills Often Hit in Emergencies

    From Drew Altman

    In an Axios column, Drew Altman previews new data highlighting that people with critical health issues are especially vulnerable to these bills.