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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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  • Newly Insured Californians Report Easier Access to Care Than the Uninsured

    News Release

    Low-income California adults who gained insurance coverage in 2014 had an easier time accessing health care than those who were uninsured and increased financial protection from medical bills, according to a new Kaiser Family Foundation (KFF) report. The report, funded by the Blue Shield of California Foundation and based on findings from the California sample of the 2014 Kaiser Survey of Low-Income Americans and the ACA, finds that newly-insured Californians were more likely to have…

  • Kaiser–Commonwealth Fund Survey: Most Primary Care Providers Report Seeing More Medicaid or Newly Insured Patients Since January 2014, But Little Change in Ability to Provide Quality Care

    News Release

    As with the Public, Physicians' Views on Affordable Care Act Split Along Party Lines The first in a series of reports on a comprehensive new survey finds most primary care doctors, nurse practitioners, and physician assistants report an increase in Medicaid or newly insured patients since the Affordable Care Act's (ACA) major coverage provisions took effect, yet little change in their ability to provide high-quality care. Overall, 59 percent of physicians and 64 percent of…

  • Early Analysis In Eleven States Finds Modest Increases For ACA Silver Plans

    News Release

    A Kaiser Family Foundation analysis of Affordable Care Act (ACA) plans in major metropolitan areas in 11 states where data are available, including the District of Columbia, finds that preliminary 2016 premiums for benchmark silver plans grew modestly, but increased more sharply this year than last year. The average increase for benchmark plans across the cities is 4.4 percent for 2016 compared with a 2 percent increase nationwide in 2015.

  • Poll: The ACA’s Pre-Existing Condition Protections Remain Popular with the Public, including Republicans, As Legal Challenge Looms This Week

    News Release

    Public Not Confident in President Trump’s Calls on Drug Companies to Lower Prices As a federal court considers a challenge to the Affordable Care Act’s constitutionality, the public, including most Republicans, wants protections for people with pre-existing conditions preserved, the latest Kaiser Family Foundation tracking poll finds. Large majorities of Americans say it is “very important” to retain the ACA provisions that prevent insurance companies from denying coverage based on a person’s medical history (75%)…

  • Implications of “Medicare for All” and “Public Plan” Strategies: New Brief and Interactive Tool Summarize Legislative Proposals and Key Issues

    News Release

    The idea of expanding the role of government programs such as Medicare and Medicaid has received renewed attention on Capitol Hill and on the campaign trail this year as policymakers consider ways to expand health insurance coverage and moderate health care costs. Lawmakers have introduced eight such proposals in the current Congress. They range from bills that would create a new, all-encompassing national health insurance program (sometimes called “Medicare-for-All”) to less sweeping measures that would…

  • Explaining the Muddle on ACA Tax Credits

    From Drew Altman

    In his latest column, KFF’s President and CEO Dr. Drew Altman looks at why the issue of extending the enhanced ACA tax credits has languished in Congress without clear direction, despite its importance to the 24 million people who get their coverage in the ACA Marketplaces today and the potentially significant role the issue could play in the midterms if the credits are not extended.

  • ¿Qué tipos de planes médicos venden los sitios web de inscripción privada?

    FAQs

    Los sitios web de inscripción privada administrados por compañías de seguros generalmente solo muestran los planes que ofrece esa aseguradora. Los sitios web administrados por corredores de seguros deben mostrar todos los planes ofrecidos por varias aseguradoras. Si tiene preguntas o inquietudes sobre la información en estos sitios, comuníquese con el centro de atención telefónica del mercado, con cuidadodesalud.gov o con el mercado de su estado. Muchos sitios web de inscripción privada también venden planes…

  • Trabajo con una visa H-2A. ¿Tengo derecho a cobertura en el mercado de seguros?

    FAQs

    Sí. Los inmigrantes con residencia legal que, de otro modo, serían elegibles para cobertura médica, incluyendo a los "no inmigrantes", como los trabajadores con visa H-2A y aquellos con visas de estudiante, pueden adquirir cobertura en los mercados de seguros. Quienes tengan bajos ingresos y sean elegibles también podrían recibir asistencia con las primas y reducciones en los costos compartidos para reducir el costo de la cobertura. Sin embargo, DACA ya no se considera un…

  • Estoy cubierta por el plan de mis padres y acabo de tener un bebé. ¿Este plan cubrirá a mi bebé después de que nazca?

    FAQs

    El plan de sus padres, independientemente de la fuente, generalmente no está obligado a cubrir a su hijo como dependiente. Dependiendo de sus ingresos, su hijo podría ser elegible para la cobertura del programa Medicaid/CHIP en su estado. O puede adquirir un plan familiar a través del mercado de seguros y, dependiendo de sus ingresos y de si su empleador ofrece seguro médico, podría ser elegible para subsidios para las primas y para costos compartidos…