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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • How Have State Medicaid Expansion Decisions Affected the Experiences of Low-Income Adults? Perspectives from Ohio, Arkansas, and Missouri

    Issue Brief

    This brief examines the experiences of low-income adults in three states that have made varied Medicaid expansion decisions: Ohio, which adopted the ACA Medicaid expansion, Arkansas which implemented the Medicaid expansion through a “Private Option” waiver, and Missouri, which has not adopted the expansion. While Arkansas and Ohio implemented the expansion in different ways, participants in both states described how obtaining coverage improved their ability to access care, contributing to improvements in their ability to…

  • Poll Finds Nearly Three Quarters of Americans Say Prescription Drug Costs Are Unreasonable, and Most Blame Drug Makers Rather Than Insurers for the Problem

    News Release

    If Supreme Court's King v. Burwell Decision Restricts Insurance Subsidies to Certain States, Most Say Congress Should Act to Ensure Residents of All States are Eligible, and a Majority in Potentially Affected States say Their State Should Act Public's Views on Affordable Care Act Are Divided and Unchanged: 42% Unfavorable and 39% Favorable Nearly three quarters (73%) of the public view prescription drug costs as unreasonable, and far more blame pharmaceutical companies more than insurers…

  • Kaiser Health Tracking Poll: June 2015

    Feature

    Given recent news about some high-cost prescription drugs and the debate about who should pay for them, this month’s Kaiser Health Tracking Poll has a special focus on the issue. Nearly three-quarters of the public think that the cost of prescription drugs is unreasonable. Americans place much of the blame with the drug companies saying they set prices too high and that company profits are a major factor in drug pricing. The poll also finds…

  • The ACA and People with HIV: Profiles from the Field

    Issue Brief

    This brief provides profiles of twelve individuals living with HIV to offer an in-depth look at how the Affordable Care Act (ACA) has affected their healthcare and coverage. Participants live in California, Florida, Georgia, New York, and Texas and discuss their enrollment and coverage experience, including whether they got new coverage (in the Marketplace or Medicaid), how their HIV care has been affected, and the role of the Ryan White HIV/AIDS Program.

  • The ACA and People with HIV: Profiles from the Field

    News Release

    New in-depth profiles of 12 people with HIV highlight how the Affordable Care Act’s coverage expansions impacted their access to coverage and care. While some experienced serious bumps along the way, those who gained coverage through Medicaid and the Marketplaces were largely able to meet both their HIV and non-HIV care needs. At the same time, the Ryan White HIV/AIDS Program continued to play a role in HIV care and coverage, both for those who remained…

  • New Evidence Health Spending Is Growing Faster Again

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Census Department survey data showing higher health spending growth over the last four economic quarters, and raises the question: is the health spending slowdown over? All previous columns by Drew Altman are available.

  • New Evidence Health Spending Is Growing Faster Again

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Census Department survey data showing higher health spending growth over the last four economic quarters, and raises the question: is the health spending slowdown over?

  • New Analysis Details Impact on Residents in Different States If the U.S. Supreme Court Rules for Challengers in King v. Burwell

    News Release

    The U.S. Supreme Court is expected to rule this month in the King v. Burwell case that challenges whether low- and moderate-income Americans are eligible for subsidies to help pay for insurance if they live in states where the federal government, rather than the state, established its new insurance marketplace under the Affordable Care Act (ACA). Using 2015 enrollment data released today, a new Kaiser Family Foundation analysis and interactive map breaks out how residents…

  • State-by-State Effects of a Ruling for the Challengers in King v. Burwell

    Interactive

    A map and table showing the number of people now receiving premium subsidies who would lose them if the Court finds for the challengers; the total amount of federal subsidy dollars; the average subsidy (or average premium tax credit) that subsidized enrollees have qualified for; and the average increase in premiums that subsidized enrollees would face if the subsidies are disallowed.