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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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  • ¿Ser lesbiana, gay, bisexual o transgénero (LGBT) afecta mi cobertura y opciones de seguro médico? ¿Qué pasa si estoy casado con mi pareja del mismo sexo?

    FAQs

    No se le puede rechazar ni cobrar más por ser lesbiana, gay, bisexual o transgénero. Tampoco se le puede negar la cobertura ni cobrarle más por una condición de salud preexistente, como su estatus serológico respecto al VIH. Las aseguradoras no pueden establecer límites anuales ni de por vida sobre cuánto gastarán en su atención médica. Además, los programas de salud que reciben fondos federales, como los planes del mercado de seguros, Medicaid y Medicare,…

  • Traté de renovar mi mismo plan para el próximo año, pero la aseguradora dice que olvidé un pago y que no me permitirán continuar con la cobertura hasta que pague la prima que debo. ¿Pueden hacer eso?

    FAQs

    No. Las aseguradoras no pueden exigir a quienes adeudan primas atrasadas que paguen la deuda antes de renovar la cobertura por un año más. Debe tener autorización para renovar, y el pago del 1 de enero no se podrá aplicar a la prima atrasada que adeude. De ahora en adelante, tenga en cuenta que las aseguradoras pueden cancelar su cobertura si no paga las primas. Si recibe subsidios para las primas por anticipado (APTC), las…

  • Webinar for Journalists: Women’s Health Under the Affordable Care Act

    Event Date:
    Event

    The Kaiser Family Foundation hosted an interactive webinar for journalists through its Media Fellowships Program: "Women's Health Under the Affordable Care Act," which took place on Thursday, February 6 from 12:30 p.m. to 1:30 p.m. ET. Now that the ACA's coverage expansions are in effect, the Foundation's latest webinar looked at how the law affects women's access to health coverage and care. The Kaiser Family Foundation's Alina Salganicoff, Vice President and Director of Women's Health Policy, and…

  • Promotional image for KFF video Health Care Unaffordability at the Macro Level

    Health Care Costs Keep Rising … Why and Who Pays?

    Video

    The U.S. spends more on health care than other large, wealthy countries. Concerns about rising costs aren't new, yet somehow we keep paying the bill. In this video, KFF’s Larry Levitt explains how we got here, who bears the consequences and why reining in spending systematically may be central to the next big health care debate.

  • Status of State Medicaid Expansion Decisions

    Interactive

    This page displays an interactive map of the current status of state decisions on the Affordable Care Act's Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.

  • Women and Health Care in the Early Years of the ACA: Key Findings from the 2013 Kaiser Women’s Health Survey

    Report

    This report addresses a wide range of topics that are at the heart of women’s health care, as well as changes that women may experience as a result of the Affordable Care Act (ACA). The findings in the report, based off a nationally representative survey conducted by the Kaiser Family Foundation, highlight differences in health care for uninsured, low-income, and minority women. Other focus areas include: coverage, access, and affordability; connections to health providers; access…

  • Key Findings: Kaiser Health Tracking Poll — November 2009

    Poll Finding

    This document contains the key findings from the November Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted November 5 through November 12, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (802) and cell phone (401, including 112 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Survey of People Who Purchase Their Own Insurance

    Poll Finding

    While most people in the U.S. get health insurance through their employer, about 14 million people under age 65 have coverage through the non-group or individual market, which has faced scrutiny recently in news reports about some insurers’ steep rate increases and in the market reforms in the new health reform law that will take effect in 2014. This survey provides insight into the current state of the non-group market and finds policyholders report that…