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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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  • Visualizing Health Policy: What Americans Pay for Health Insurance Under the ACA

    Other Post

    The March 2014 Visualizing Health Policy infographic shows examples of what Americans will pay for health insurance under the Affordable Care Act, using different scenarios for 40-year-old individuals living in different parts of the country. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). The full-size infographic is freely available on JAMA’s website and is published in the print edition of the journal. >>View source slides

  • The Utah Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of the population health, health coverage, and health care delivery in Utah in the era of health reform.

  • Health Reform and Medicare: Overview of Key Provisions Tutorial

    Interactive

    This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org. To download this or other tutorials, visit the tutorials archive page.  Slides are available for download using the "Download Slides" link within the…

  • What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence

    Issue Brief

    Medicaid now covers more than 1 in every 5 Americans, and millions of uninsured individuals will become newly eligible for Medicaid under the ACA. Considering Medicaid’s large and growing coverage role, an evidence-based assessment of the program’s impact on access to care, health outcomes, and quality of care is of major interest. This brief takes a look at what the research literature shows regarding the difference Medicaid makes.

  • Employer-Sponsored Family Health Premiums Rise a Modest 4 Percent in 2013, National Benchmark Employer Survey Finds

    News Release

    Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2013 Employer Health Benefits Survey. This year's rise in premiums remains moderate by historical standards. The 15th annual Kaiser/HRET survey of more than 2,000 small and large employers provides a detailed picture of the status…

  • Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

    Issue Brief

    This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.