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The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

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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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  • I received a Form 1095-A from the Marketplace. What is that?

    FAQs

    Form 1095-A gives you information about the amount of advance premium tax credit (APTC) you received during the previous year. A copy of this form is also reported to the IRS. Keep this form with your other tax records. The APTC you received was based on the annual income you estimated you would earn when you signed up for Marketplace coverage. Now you must file a federal income tax return to compute your actual income for that coverage…

  • I had a Marketplace plan last year, but paid the full premium myself because I made too much to qualify for premium tax credits. When I did my taxes though, my income for the year ended up being less th...

    FAQs

    Yes. Premium tax credits can be claimed in advance (during the year) or when you file your taxes. To claim the credit, you will need to file a federal income tax return and Form 8962. Follow the instructions on Form 8962 to determine the amount of tax credit you should receive as a refund when you file your taxes.

  • What is Form 8962?

    FAQs

    If you received an advanced premium tax credit (APTC) through the Marketplace last year, you must file a Form 8962 with your federal income tax return in order to "reconcile" your estimated and actual income for the year, even if you estimated your income perfectly. You can get a blank Form 8962 from the IRS website, or, if you use tax preparation software, the form will be automatically generated for you. The instructions for Form…

  • What happens if I’m late with a monthly health insurance premium payment?

    FAQs

    It depends on whether you are receiving advanced premium tax credits. If you receive a premium tax credit, your insurer must provide a 90-day grace period to pay all past-due premiums. If the amount owed for all outstanding premium payments is not paid in full by the end of the grace period, the insurer can terminate coverage. However, the grace period only applies if you have paid at least one month’s premium within the current…

  • I have COBRA, but it’s too expensive. Can I drop it during Marketplace Open Enrollment and enroll in a Marketplace plan instead?

    FAQs

    During Marketplace Open Enrollment, you can sign up for a Marketplace plan even if you already have COBRA. You will have to drop your COBRA coverage effective on the date your new Marketplace plan coverage begins. After Marketplace Open Enrollment ends, however, if you voluntarily drop your COBRA coverage or stop paying premiums, you will not be eligible for a special enrollment opportunity to enroll in a Marketplace plan and will have to wait until…

  • I heard the Affordable Care Act’s individual mandate ended. Does it still make sense to sign up?

    FAQs

    While there is no longer a federal tax penalty for being uninsured, some states (CA, MA, NJ, and RI) and DC have enacted individual mandates and may apply a state tax penalty if you lack health coverage for the year. Regardless of any tax penalty, it is still important to have insurance coverage to help reduce the risk of large medical bills if you get sick, to pay for medications, and to pay for check-ups…

  • I heard that health plans sold on the Marketplace no longer have to cover certain preventive services. Is that true?

    FAQs

    No, this is not true. Health plans sold on the Marketplace are still required to cover certain preventive services without any patient cost sharing. The categories of preventive services Marketplace plans must cover are: Evidence-based screenings and counseling Routine immunizations Childhood preventive services Preventive services for women Click here for more information on covered preventive services.

  • I am self-employed and my income varies from year to year. How do I apply for premium tax credits if I don’t know what my income will be next year?

    FAQs

    When you apply for the premium tax credit, you will be asked to estimate your expected income for the upcoming year. Often a good place to start is to consider what your income is this year, or what income you reported on your tax return last year. However, if your circumstances have changed since then, you should make your best estimate of what your income will be next year. For example, if you recently lost…

  • I had a Marketplace plan last year and received advanced premium tax credits. Since the Marketplace already determined that I was eligible for the tax credit, do I still have to file a federal income ta...

    FAQs

    Yes. You are required to file a federal income tax return for any year in which you received advanced premium tax credits. When you file, you will have to calculate how much tax credit you were actually eligible for in that year. The Marketplace determination you received last year was based on your good-faith estimate of what your annual income would be.  When you file your tax return, you will need two special tax forms: Form 1095-A and Form…

  • What is the health insurance Marketplace?

    FAQs

    Health insurance Marketplaces (also known as Exchanges) are organized markets where individuals and families can shop for and enroll in health insurance online, over the phone, or in person. Marketplaces offer a choice of different health plans, certify plans that participate, and provide information to help consumers understand their options and apply for coverage. There is a health insurance Marketplace in every state. Some are operated by the state and have a special state name (such as…