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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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  • New Kaiser 50-State Survey Provides Data on States’ Medicaid and Children’s Health Insurance Program Eligibility Levels and Enrollment, Renewal and Cost-Sharing Policies as of January 2015

    News Release

    A new survey from the Kaiser Family Foundation provides a comprehensive look at where states stand with their Medicaid and Children’s Health Insurance Program (CHIP) eligibility levels and enrollment, renewal and cost-sharing policies as of January 2015, one year into implementation of the Affordable Care Act’s major coverage provisions. The 13th annual survey, conducted by the Foundation’s Kaiser Commission on Medicaid and the Uninsured and Georgetown University’s Center for Children and Families, finds that states…

  • Kaiser Health Policy News Index: July 2014

    Feature

    The July Kaiser Health Policy News Index finds the most closely followed news stories this month were discussions about how to deal with large numbers of unaccompanied minors arriving in the U.S. from Central America, military and political conflict between Israel and Hamas, and ongoing problems related to Veterans Affairs (or V.A.) medical facilities. Six in ten report closely following the Supreme Court’s decision in a case about whether for-profit companies should be required to…

  • Kaiser Health Tracking Poll: July 2014

    Feature

    The July Kaiser Health Tracking Poll finds that over half the public has an unfavorable view of the Affordable Care Act (ACA) in July, up eight percentage points since last month, while the share viewing the law favorably held steady at just under four in ten. This month’s poll also explored the public’s reaction to the Supreme Court decision upholding craft store chain Hobby Lobby’s ability to deny workers coverage of certain contraceptives based on…

  • Kaiser Health Policy News Index: April 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month’s Index finds that the public followed the missing Malaysia Airlines flight, the shooting at the Fort Hood army post, and the conflict between Ukraine and Russia, more closely than any health policy news stories. Among health…

  • Kaiser Health Policy News Index: March 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month’s Index finds that the public followed the missing Malaysia Airlines flight and the conflict between Ukraine and Russia more closely than news about ACA enrollment. Additionally, many Americans remain unaware of the status of Medicaid expansion…

  • KFF Health Tracking Poll – February 2019: Prescription Drugs

    Feature

    With increased national attention towards prescription drug costs, this poll examines the public’s experiences with prescription medicine and their views on current policy proposals brought forth by congressional lawmakers and the Trump administration, including international reference pricing, transparency in drug advertisements, and negotiations with drug companies. The survey also dives into the attitudes and experiences of adults, 65 and older – a group that is more likely to report taking prescription medication and shopped for…

  • KFF Health Tracking Poll – November 2018: Priorities for New Congress and the Future of the ACA and Medicaid Expansion

    Feature

    Fielded a week after the 2018 midterm elections, this poll examines the public’s priorities for the next Congress, measures favorability for ACA provisions including Medicaid expansion, and takes a look at knowledge of the current open enrollment period among adults ages 18-64 who purchase their own insurance or are currently uninsured. With the impending Texas v. United States lawsuit, in addition to several Trump administration policy actions aimed at different aspects of the U.S. health…

  • Kaiser Health Tracking Poll: June 2016

    Feature

    The June Kaiser Health Tracking Poll examines attitudes on the Affordable Care Act and provides an in-depth analysis of two of the biggest health policy stories of the month: the Zika virus outbreak and reports about the rising costs of ACA health insurance premiums.