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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

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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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  • Medicaid as a Potential New Third Rail of US Politics

    Perspective

    In this JAMA Forum column, KFF's Larry Levitt examines Medicaid's growing political importance and the potential double whammy that could hit state Medicaid programs next year with the end of the COVID-19 public health emergency and a possible simultaneous recession.

  • Health Policy News Index, August-September 2014: Ferguson And International Conflicts Capture Public’s Attention

    Kaiser Health Policy News Index: August-September 2014

    Feature

    The latest Kaiser Health Policy News Index finds that attention to health policy stories in August took a back seat to breaking national news such as the unrest in Ferguson, Missouri, international events in the West Bank, Syria and Ukraine and a global health story, the Ebola outbreak in West Africa. The only U.S. health policy news story that garnered a significant amount of public attention this month was the passage of a bill in…

  • Kaiser Health Policy News Index: February 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month’s Index finds that the implementation of the Affordable Care Act (ACA) was the most-closely followed health policy news story this month, ranking behind news of the U.S. economy. The survey also finds that the news media…

  • Kaiser Health Policy News Index: January 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month's index looks at the public’s attention to the ongoing rollout of the Affordable Care Act (ACA), as well as other news stories including the release of a major government study on health care costs.

  • Kaiser Health Tracking Poll: January 2014

    Feature

    With enrollment in new coverage options underway, a majority of the public believes that only “some” of the ACA’s provisions have been put into place, while just about one in five think “most” or “all” of the law has been implemented. Awareness of the law’s individual mandate and health insurance exchanges has increased slightly since last year, but about four in ten of the public overall and half the uninsured remain unaware of other major…

  • Kaiser Health Policy News Index: March 2015

    Feature

    The public paid more attention to news coverage of the measles outbreak in the U.S. and the resulting debate on whether vaccinations should be required for all kids than any other news story included in this month's Kaiser Health Policy News Index. Nearly half correctly identified that the number of confirmed measles cases in the U.S. since the outbreak began late last year is closer to 100, and most say they are not too or…

  • JAMA Forum: Of SCOTUS and Chicken

    Perspective

    Larry Levitt's March 2015 post explores what could happen if the U.S. Supreme Court rules for the plaintiffs in the King v. Burwell case, the lawsuit that challenges the federal government’s authority to provide financial assistance to people who buy insurance in federally-operated marketplaces created by the Affordable Care Act.

  • The Effects of the Medicaid Expansion on State Budgets: An Early Look in Select States

    Issue Brief

    This brief examines the early state budget effects of the ACA Medicaid expansion in three states: Connecticut, New Mexico, and Washington State. States were asked about savings and costs in Medicaid, behavioral health, corrections, uncompensated care spending, etc. as well as revenues. Findings from a study looking at Kentucky are also included.

  • The Health-Care Enrollment Story Is in the States

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the U.S. Department of Health and Human Services. All previous columns by Drew Altman are available online.

  • Kaiser Health Tracking Poll: January 2015

    Feature

    The latest Kaiser Health Tracking Poll finds though few Americans are paying attention to the pending Supreme Court case over whether the health care law says that people in all states can get financial help to buy health insurance, most say they would want Congress and their state to act to fix potential gaps should the Supreme Court rule in favor of the plaintiffs. With a new Republican majority controlling both Houses of Congress, the…