Home Affordable Care Act Topics

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?

Latest News

More KFF Health News

Stay informed.

Get KFF's latest on the Affordable Care Act

Stay informed.

Get KFF's
latest on the Affordable
Care Act

View the Latest: Affordable Care Act

Filter

List Grid

1,561-1,570 of 2,788 results

  • Kaiser Health Tracking Poll: April 2016

    Report

    The April Kaiser Health Tracking Poll examines the role of health care issues in the presidential election. Health care is one of the top four issues mentioned by voters when asked which issues they most want to hear candidates discuss in the campaign, but half as many cite health care as mention the economy and jobs. It also examines the public’s experiences with prescription painkiller abuse and access to mental health care, as well as…

  • Amid Primary Debate about Universal Coverage, Most Democrats Now Want to Expand the Affordable Care Act, Leading to Somewhat Less Favorable Views of the Law Itself

    News Release

    Voters Rank Health Care Fourth As Issue for Presidential Candidates to Discuss With the Democratic presidential primary featuring a debate about how to get to universal health coverage in the United States, the latest Kaiser Health Tracking Poll finds most Democrats want Congress to expand the Affordable Care Act, contributing to a widening gap between unfavorable and favorable views of the health reform law. Overall the poll finds that this month 49 percent of the…

  • Clinton-Sanders Contest Fuels Democratic Support for Expanding Obamacare

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses how the debate between Hillary Clinton and Bernie Sanders about how to get to universal coverage has generated more support among Democrats for expanding the Affordable Care Act (and less support for the law as is).

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • Quick Take: Key Considerations in Evaluating the ACA Medicaid Expansion for States

    Fact Sheet

    A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges.  Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have substantial consequences for health coverage for the low-income population. The 3 key questions that states should consider in…

  • Consumer Choice in Health Care: How Could Reform Affect Our Choices? How Could We Make Better Choices?

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this event which brought together nationally known health policy experts for a conversation on consumer choice in health care. Panelists addressed the following questions: Why is choice of health care providers important? How much choice do we really have now? How much choice do we need? How might health reform affect our choices? In some instances, do we have too much choice? How…

  • Study Finds Recent Slowdown in Health Spending Growth Mostly Tied to the Economy

    News Release

    Growth Expected To Move Towards Historical Levels In Coming Years As the Economy Recovers A new Kaiser Family Foundation analysis of how the economy affects the nation’s health spending concludes that the record slow growth rate of recent years stems largely from economic factors beyond the health system, with the economy explaining 77 percent of the slowdown, and more rapid growth expected in coming years if the economy strengthens as expected. Based on statistical modeling…

  • Explaining Health Care Reform: Medical Loss Ratio (MLR)

    Fact Sheet

    This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and…

  • The Requirement to Buy Coverage Under the Affordable Care Act

    Other Post

    Note:  Congress eliminated the federal tax penalty for not having health insurance, effective January 1, 2019. Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay a penalty. This simple flowchart illustrates how that requirement (sometimes known as an "individual mandate") works.     >>Download the PDF