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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

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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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  • 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.

  • KFF Election Tracking Poll: Health Care in the 2018 Midterms

    Feature

    In an expansive look at the 2018 midterm elections, this month's KFF Health Tracking Poll includes an in-depth examination of the role health care may be playing in midterm elections nationally, as well as in Florida and Nevada, two bellwether states in which candidates from both parties are talking about health care issues. Health care remains a top priority for Democrats and independents, but ranks lower for Republicans, behind immigration and the economy and jobs.…