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

1,651 - 1,660 of 2,787 Results

  • The ACA is Doing Fine Without a Mandate Penalty

    From Drew Altman

    In an Axios column, Drew Altman explains that the elimination of the Affordable Care Act’s individual mandate penalty has had little impact on how the ACA’s insurance markets are working, showing that “the marketplaces continue to function, even when 'severed' from the mandate penalty,” and undercutting a central argument in the lawsuit seeking to strike down the entire law.

  • Pre-Existing Condition Prevalence for Individuals and Families

    Issue Brief

    This analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. Almost half (45%) of non-elderly families include at least one adult with such a pre-existing condition. The analysis also includes estimates by age, state and gender.

  • JAMA Forum: What is Trumpcare?

    Perspective

    The debate among Democratic presidential candidates about how to reform the health care system largely boils down to whether to build on the Affordable Care Act and create an option for people to enroll in Medicare or create a Medicare for all plan that covers everyone. On the other side of the partisan divide, President Trump has repeatedly promised a health care plan, but not yet delivered one. The president has vowed to repeal the…

  • Workers Aren’t So Sure “Medicare for All” Would Raise Their Wages

    From Drew Altman

    Drew Altman’s latest Axios column dives into an issue raised in a Joe Biden and Bernie Sanders exchange. In a Medicare-for-all system employers could reap large savings from not having to provide workers health care coverage, but do workers trust that those savings will be passed to them in higher wages?

  • Recent and Anticipated Actions to Reverse Trump Administration Section 1557 Non-Discrimination Rules

    Issue Brief

    The Biden Administration has started taking steps to reverse Trump Administration policy and regulations that significantly narrowed the implementation and administrative enforcement of Section 1557, the Affordable Care Act’s nondiscrimination provision, particularly as the regulations apply to gender identity and sexual orientation. In addition, several lawsuits challenging the regulations, which were initially issued by the Obama Administration and later substantially revised by the Trump Administration, are pending. Section 1557 prohibits discrimination based on race, color,…

  • Medicare and Dental Coverage: A Closer Look

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. This brief provides new data on the share of Medicare beneficiaries with dental coverage, the share with a dental…

  • Analysis: Insurer Financial Indicators Show Signs of Stabilizing After Transition to ACA Marketplaces

    News Release

    A new Kaiser Family Foundation analysis of key insurer financial indicators suggests that the individual insurance market showed signs of stabilizing in 2016, although profitability remained below the level of performance prior to the opening of the Affordable Care Act’s insurance marketplaces. The new analysis tracks insurer financial performance in the individual market through two key indicators: average medical loss ratios (the share of health premiums paid out as claims) and average gross margins per…

  • No, Medicaid Isn’t Broken

    From Drew Altman

    With Medicaid about to be a focal point of debate in the Senate, Drew Altman's Axios column looks at why the idea that the program is broken is more urban legend than fact.