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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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  • Is There a Health Care Vote? More for Democrats and Women than Other Groups

    News Release

    About One Third of Americans Perceive Wide-Scale Effort to Limit Women’s Reproductive Health Choices and Services; Most Who Do Say the Effort is a ‘Bad Thing’ Health care is one of many issues that will be important for voters in the presidential election, particularly for Democrats and women, finds the March Kaiser Health Tracking Poll. More than a third (36%) of voters consider health care “extremely important” to their vote in this year’s presidential election,…

  • The Affordable Care Act After Six Years

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do. All previous Drew Altman columns are online.

  • The Affordable Care Act After Six Years

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do.

  • Visualizing Health Policy: Recent Trends in Prescription Drug Costs

    News Release

    This Visualizing Health Policy infographic spotlights national spending on prescription drugs and the public’s views on pharmaceutical prices. Prescription drug spending rose sharply in 2014, driven by growth in expenditures on specialty drugs, including medications to treat cancer and hepatitis C. Medicare’s spending on prescription pharmaceuticals also has risen, largely due to the addition of the Medicare prescription drug benefit in 2006: between 2004 and 2014, the program’s share of US drug expenditures increased from…

  • Snapshot of Where Hillary Clinton and Donald Trump Stand on Seven Health Care Issues

    Issue Brief

    Where do the 2016 Presidential candidates, Hillary Clinton and Donald Trump, stand on key health care issues? This snapshot outlines the candidates' positions and policy statements on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, women's reproductive health, and Zika.

  • What’s Driving the GOP Health Plan

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on May 30, 2014. Conservative House Republicans are pushing for a vote on a GOP health-care plan, presumably to appeal to their base, to give GOP candidates health reform ideas to talk about on the campaign trail and to show that they have a policy position beyond repealing the Affordable Care Act. Polling shows they have a ways to go. The Kaiser Family Foundation’s May tracking poll…

  • Medicaid Enrollment Snapshot: December 2013

    Issue Brief

    This report focuses on changes in monthly Medicaid enrollment between December 2012 and December 2013. This is a long standing report series that collects monthly Medicaid enrollment data for December (and June, not reported here) going back to 2000. While the most recent data included in this report predate preliminary data released by CMS that show the early effects of full implementation of the ACA, this report series is an important source of historical trend…

  • Strategies in 4 Safety-Net Hospitals to Adapt to the ACA

    Issue Brief

    This brief examines four safety-net hospitals to learn how they were preparing for the full implementation of the Affordable Care Act (ACA), in order to gain additional insight into the strategies being used and challenges being faced among safety-net hospitals across the country.

  • How Much Political Coverage of the Health-Care Law Is Too Much?

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 5, 2014. With primaries underway and the midterms approaching, coverage of the Affordable Care Act will increasingly focus on politics. Many political reporters may take temporary control of the health-care beat during the leadup to November. News organizations should consider: How much Affordable Care Act political coverage is too much? Already, the public says that coverage of the ACA is mostly about politics rather…