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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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  • An Update on Coverage for Preventive Services Under the Affordable Care Act

    News Release

    An updated fact sheet from the Kaiser Family Foundation summarizes the latest information on health plan coverage of preventive services under the Affordable Care Act. The fact sheet details the rules that govern when plans are required to cover services without cost-sharing and which services are covered. In addition, the fact sheet summarizes the clarifications issued by the U.S. Department of Health and Human Services on coverage for a number of services including: colon cancer…

  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election. All previous columns by Drew Altman are available online.

  • ACA Advertising in 2014 – Insurance and Political Ads

    Report

    This study analyzes the volume and content of political ads mentioning health care issues that aired in 2014 through Oct. 15, as well as health insurance spots promoting specific insurance products or encouraging enrollment in marketplace plans. It finds that about 14 percent of political ads in all races mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way.

  • New Analysis Finds the Affordable Care Act Mentioned in 14% of This Year’s Political Ads

    News Release

    Republican Ads Were Much More Likely to Mention ACA, Often in Spots that Also Hit Other Issues About 14 percent of political ads in all races airing this year through October 15 mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way, a new Kaiser Family Foundation study finds. Overall, about a quarter (26%) of political spots airing so far this year mention health care issues, including…

  • New Kaiser Survey of People with Non-Group Insurance Finds Nearly Six in 10 People Enrolled in Marketplace Plans Were Previously Uninsured

    News Release

    People in ACA-Compliant Plans Are Somewhat More Likely To Say They Are in Fair or Poor Health Than Those in Non-Compliant Plans People Who Switched Plans Due to Cancellation Notices or Other Reasons Are As Likely To Say Their Premiums Went Down As Went Up Overall About As Many People in This Market Feel They Benefited From the ACA As Feel Negatively Impacted, With Variations By Sub-Group The first in a series of new surveys…

  • Kaiser Health Tracking Poll: June 2014

    Feature

    As many employers begin to expand their wellness programs under new guidelines set forth by the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds workers oppose programs that make them pay higher premiums if they fail to participate or meet specific health goals. Overall public opinion of the ACA remains about the same as it has for the last several months, with a somewhat higher share of the public continuing to express…

  • Kaiser Health Policy News Index: June 2014

    Feature

    This month's Health Policy News Index finds more than six in 10 say they followed news about long waiting lists for those seeking care at Veterans Affairs (VA) medical facilities closely. That makes the VA story the most closely followed health story in the first half of 2014, with slightly more people following it than followed several ACA enrollment stories earlier this year.

  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…

  • Why the Political Heat on the ACA Is Cooling

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores some early indicators that the political waters may be calming for the Affordable Care Act.

  • Sen. Mark Pryor Spotlights the Health Law’s Rx for Pre-Existing Illnesses

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why Senator Mark Pryor’s new campaign ad features the Affordable Care Act’s protections for people with pre-existing medical conditions, the somewhat forgotten “mega provision” of the law. All previous columns by Drew Altman are available online.