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

151 - 160 of 2,788 Results

  • What happens after the COBRA subsidies end in September?

    FAQs

    You can continue on COBRA unsubsidized until your 18 months of COBRA eligibility ends. In addition, you will have the option to enroll in marketplace coverage when the subsidy ends in September.  Loss of the COBRA subsidy will make you eligible for a special enrollment period (SEP) to sign up for marketplace coverage.  If you make your plan selection before the end of September, new marketplace coverage will take effect on October 1. 

  • I notice something called “Easy pricing” under the plan name on HealthCare.gov. What does that mean?

    FAQs

    "Easy pricing" refers to a "standardized" plan design on HealthCare.gov that aims to make it simpler to compare plans by applying the same to each category of essential health benefits across all easy pricing plans in the same metal level. For example, all Bronze-level easy pricing plans have the same deductible and copays. By contrast, non-standardized Bronze-level plans might have different deductible and copay amounts. Easy pricing plans are marked with a green circle with…

  • I hear there is a special enrollment opportunity for people with very low income. How does that work?

    FAQs

    Starting August 25, 2025, the special enrollment opportunity that allowed individuals with incomes at or below 150% of the federal poverty level to sign up for Marketplace coverage year-round --simply due to their low income --was eliminated. Individuals at this income level might still qualify for special enrollment under other special enrollment events, such as when they lose coverage due to job loss or lose Medicaid coverage.

  • Do I have to renew Medicaid coverage every year?

    FAQs

    Yes. States must redetermine Medicaid eligibility for most enrollees every 12 months. When your coverage period is ending, you will receive a notice from the state. If your coverage has been automatically renewed, the notice will indicate the new coverage period. If your coverage has not been automatically renewed, the notice will include instructions for completing the renewal process. Note that the renewal process might look different depending on where you live. Click here for a…

  • I notice “short-term limited-duration” insurance plans for sale outside of the Marketplace, and they are cheaper than many other health plans. What is a short-term limited-duration health plan?

    FAQs

    “Short-term limited-duration” insurance plans are intended to fill a temporary gap in health coverage, such as when someone is between jobs. The maximum duration of short-term plans varies by state. Short-term plans must disclose to consumers that these plans are “NOT comprehensive health coverage.” Short-term plans often do not have the consumer protections found in Marketplace plans. For example, short-term plans can exclude coverage of pre-existing health conditions. Also, many short-term plans do not cover essential health…

  • Can I be charged more if I have a pre-existing health condition?

    FAQs

    Not if you're buying a Marketplace plan. Marketplace plans are not allowed to charge you more based on your health status or pre-existing health condition. Some plans that are sold off the Marketplace, such as short-term plans and health sharing ministries, can turn you down or charge you more based on your health status or pre-existing condition. Click here for information on what to look for if you’re considering shopping for a plan off the…

  • I notice “Catastrophic plans” that look even cheaper than other Marketplace plans. What are those, and can I buy one?

    FAQs

    Catastrophic plans have the highest cost sharing and lowest premiums. In 2026, Catastrophic plans will have an annual deductible of $10,600 for an individual or $21,200 for a family. The plan does not have to cover more than three primary care visits before the deductible has been met. Catastrophic plans may only be sold to certain individuals. See this FAQ for details. Note that if you are eligible for financial assistance on the Marketplace, it…

  • Where can I get help with my Marketplace application?

    FAQs

    All Marketplaces are required to offer "Navigator" programs to help consumers review their plan choices, complete their application, or apply for financial assistance. Navigators can also assist consumers applying for Medicaid or CHIP. Additionally, Navigators can help consumers with post-enrollment support, such as appealing Marketplace decisions. Navigators are paid by the Marketplace, not by health plans, and they must complete Marketplace training and be free from conflicts of interest. You may also be able to…