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

1,681-1,690 of 2,788 results

  • Issue Brief Explores Consequences of Potential Supreme Court Decisions on the ACA Contraceptive Coverage Requirement

    News Release

    A new Kaiser Family Foundation issue brief explores some of the factors influencing employers’ coverage decisions and possible consequences for employers and workers that could arise from possible Supreme Court decisions in the cases brought by Hobby Lobby and Conestoga Wood Specialties, for-profit corporations challenging the Affordable Care Act’s requirement to cover contraceptive services and supplies in health insurance. Other resources about the Supreme Court case are also available online.

  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion Decisions in the South

    Other Post

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the South remain…

  • What’s Trending in Health Care? Conservative Ideas

    News Release

    What’s Trending in Health Care? Conservative Ideas In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system. All previous columns by Drew Altman are available online.

  • How Obamacare’s Progress Makes Expanding Coverage Harder

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on July 21, 2014. The Affordable Care Act’s success meeting its initial enrollment goals and the repair of HealthCare.gov seem to have calmed the political waters for Obamacare. But the job of enrolling the uninsured gets harder, not easier, because the remaining uninsured will generally be tougher to reach. Recent surveys show, roughly in line with expectations, that 8 million to 9.5 million fewer adults are uninsured compared with last year before…

  • Trends in Employer-Sponsored Insurance Offer and Coverage Rates, 1999-2014

    Issue Brief

    This issue brief uses data from the National Health Interview Survey (NHIS) to examine trends in employer-sponsored health insurance (ESI) for different of individuals and households in the United States. While ESI remains the leading source of coverage for nonelderly people, the percentage covered by an employer plan has declined over the past 15 years. A similar pattern exists with firm offer rates; fewer workers were offered health insurance from their employer in 2014 than…

  • How Private Health Coverage Works: A Primer – 2008 Update

    Issue Brief

    How Private Health Coverage Works: A Primer— 2008 Update This primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations that operate under the federal Employee Retirement Income Security Act (ERISA). The primer discusses the fundamental aims of private health coverage and sorts out…

  • Pulling It Together: What Do We Want Health Insurance To Be?

    Perspective

    Trends in the health insurance marketplace show substantial growth in high deductible health plans, especially among smaller firms, where 35% of workers are now covered by plans with a deductible of $1,000 or more. That's according to our recently released employer health benefits survey, which we have been conducting now for ten years. The majority of these plans are simply high deductible health plans; only a minority are so-called "consumer driven" plans with savings accounts.…

  • Community Health Centers in an Era of Health System Reform and Economic Downturn: Prospects and Challenges

    Issue Brief

    This issue brief reviews the role of community health centers in the nation's health care safety net. The centers provided comprehensive primary care to 16.1 million patients in 2007, many of them from lower-income families and medically underserved communities. The role of the centers is even more critical during an economic recession when families are more vulnerable to economic loss and unmet health needs. Issue Brief (.pdf)

  • Today’s Topics In Health Disparities: The Effect of the Economic Downturn on the Health of Communities of Color

    Event Date:
    Event

    Transcript (.pdf) On Wednesday, March 25, the Kaiser Family Foundation held a live, interactive webcast to examine the economic downturn’s impact on health care in communities of color as part of its Today's Topics In Health Disparities series. Rising unemployment has left many families uninsured and increasingly strained family finances are prompting some Americans to cut back on medications and forgo preventive care. The panel discussed these and other potential implications of the economic crisis,…