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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?

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  • Who Will be the H&R Block and TurboTax for Health Insurance?

    Perspective

    There's been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as "producers"). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that would exempt agent and broker commissions for health insurance from minimum medical loss ratio (MLR) thresholds established in the health reform law. (The MLR is…

  • KFF/Harvard Survey on Public’s Health Care Agenda for the 112th Congress Finds An Uptick in Public Opposition to Health Reform As GOP Ramped Up Repeal Campaign

    Perspective

    Though the public remains divided on health reform overall, according to a new survey jointly conducted by the Kaiser Family Foundation and Harvard School of Public Health, opposition to the new law ticked upward in January from 41 percent to 50 percent as Republicans ramped up efforts to repeal it. The survey also showed that there is no groundswell of public support for overturning the law, with 47 percent wanting to either expand the law…

  • Kaiser November Tracking Poll Finds Health Care a Factor in Congressional Election, But Not a Dominant One

    Perspective

    This month’s Kaiser Health Tracking Poll, conducted during the four days following the mid-term election, asked voters in an open-ended question to name in their own words the biggest factors influencing their vote for Congress, and found that health care was a factor, but not a dominant one. Among all voters, the factor mentioned most often was the economy/jobs (29%). The next two most mentioned factors were party preference (25%) and views of the candidates…

  • Health Affairs Issue Focuses on Health Reform

    Perspective

    The June 2010 issue of the journal Health Affairs is dedicated to health reform, and "begins to tackle the hundreds of implementation issues inherent in health reform and offers prescriptions for averting trouble," according to Editor-in-Chief Susan Dentzer. The issue features an article by Kaiser researchers examining past and present polling related to reform and showing how a surprisingly stable public opinion tracked with historic patterns, even if the contentious public debate suggested a volatile…

  • KFF Explores Health Reform and the Tea Party Movement

    Perspective

    With much media discussion of the role that the Tea Party will play in the upcoming congressional midterm elections, the Kaiser Family Foundation took a closer look at Tea Party supporters using its most recent Health Tracking Poll data from September. While 57 percent of voters who do not support the Tea Party movement view the health reform law favorably, 57 percent of Tea Party supporters view the law "very" unfavorably, and another 11 percent…

  • What Issues Are Most Important To Voters in This Election? The Answer Depends On The Question

    Perspective

    Election polling has entered hyperdrive, with several polls released daily. As Nov. 6 draws near, it is important to keep in mind that question wording and format do matter, sometimes quite a lot. In our October Kaiser Health Tracking Poll, we measured voters’ top issue priorities two ways: First, we asked one group to name the most important issue to their vote for president in an open-end question, allowing respondents to say in their own…

  • Insurance Coverage of Contraceptives

    Perspective

    In this post, we answer some of the key questions about the new contraceptive coverage policy generally, and more specifically, how it will be applied to religious organizations.

  • August Kaiser Health Tracking Poll: A Look At The GOP As The Republican Convention Draws Near

    Perspective

    Despite the ongoing focus on Republican opposition to the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds that the ACA is not the top health care priority among Republicans. While jobs are still the number one issue, when asked about the health care issues that will impact their vote this fall, Republicans’ top concern was the cost of health care and insurance, named by two-thirds as either “extremely” or “very important” to…

  • Transparency and Complexity

    Perspective

    This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC).  The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies. The SBC is one of the most popular provisions of the ACA.  Consumers often find health insurance difficult to understand and would no doubt welcome a plainly written…

  • KFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision

    Perspective

    As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether the law overall will leave their own families better off (26 percent), worse off (33 percent), or if it won’t make much difference (34 percent).…