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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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  • JAMA Forum: Those Pesky Lines Around States

    Perspective

    In this post for The JAMA Forum, the Kaiser Family Foundation's Larry Levitt discusses the concept of allowing insurers to sell health plans across state lines and how such a proposal could affect people with pre-existing conditions.

  • Kaiser Health Tracking Poll: November 2016

    Feature

    The November Kaiser Health Tracking Poll, conducted one week after the 2016 presidential election, finds health care played a limited role in voters’ 2016 election decisions. While President-elect Trump and Republican lawmakers have made it clear that one of their top priorities is the repeal of the Affordable Care Act, the survey finds Americans are divided on what they want to see lawmakers do to the health care law. This survey also finds that many…

  • After the Election, the Public Remains Sharply Divided on Future of the Affordable Care Act

    News Release

    Among Those Who Favor Repeal, Arguments About Loss of Coverage for Those with Pre-Existing Conditions Can Sway Some Opinions Many Obamacare Provisions Remain Broadly Popular Across Party Lines, But Not its Mandate The first Kaiser Health Tracking Poll since the 2016 election finds that Americans are largely divided on the future of the Affordable Care Act even though many of the law’s major provisions remain quite popular across party lines. The new survey finds that…

  • Analysis of 2016 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

    Fact Sheet

    The chart and tables below present an updated analysis of changes in premiums for the lowest- and second-lowest cost silver Affordable Care Act (ACA) marketplace plans in major cities in 48 states and the District of Columbia, where we were able to find complete data on rates for all insurers. This page will be updated as complete rate information becomes available for more states. More background can be found in our earlier analysis of 2016…

  • Tracking Section 1332 State Innovation Waivers

    Fact Sheet

    This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore up fragile insurance markets, address unique state insurance market issues, or experiment with alternative models of providing coverage to state residents.

  • The Republican Base is Getting Less Excited About Health Care

    From Drew Altman

    In this Axios column, Drew Altman explains that as Republican policymakers are focused on delivering a repeal of Obamacare for their base, polling shows that it’s not a top priority for Trump supporters, and their intensity on a replacement plan has declined, suggesting that the issue may not drive turnout for future elections.

  • Medicaid’s Role in Colorado

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Colorado. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Colorado.

  • Medicaid’s Role in Louisiana

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Louisiana. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Louisiana.

  • Medicaid’s Role in Ohio

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Ohio. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Ohio.