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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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  • Proposed Medicaid Expansion in Utah

    Fact Sheet

    This fact sheet provides a summary of the proposal to expand Medicaid in Utah. This has not been officially submitted to CMS and needs state legislative approval before it could be implemented.

  • Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

    Issue Brief

    This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.

  • Which Path for Health-Care Politics in 2015?

    News Release

    In his first 2015 column for The Wall Street Journal's Think Tank, Drew Altman explains why this year, status quo for the Affordable Care Act is not an option and how the Supreme Court rules in King v. Burwell will determine its path. All previous columns by Drew Altman are available online.

  • Which Path for Health-Care Politics in 2015?

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on January 6, 2015. Yogi Berra said that when you come to a fork in the road, take it. It will be that kind of year for health-care politics. The status quo is not an option. The key to which path the Affordable Care Act takes is how the Supreme Court rules in King v. Burwell, the case that concerns whether subsidies in the health law can be…

  • Issue Brief Looks At Experiences of People with HIV With Health Coverage Under the ACA

    News Release

    A new Kaiser Family Foundation issue brief examines the impact of the Affordable Care Act (ACA) on people with HIV in five states – California, Florida, Georgia, New York and Texas. Findings are drawn from focus groups in which participants discussed their experiences during the first year of the ACA’s major coverage expansions, with the goal of understanding the implications for individual HIV health outcomes and the nation's response to the epidemic. While many focus group…

  • Health Insurance Coverage for People with HIV Under the Affordable Care Act: Experiences in Five States

    Issue Brief

    To provide greater insight into how Affordable Care Act (ACA) implementation has affected people with HIV during the first year of major insurance expansions, this issue brief examines the experiences of people with HIV based on focus groups conducted in five states: California, Florida, Georgia, New York, and Texas. It is a part of KFF's larger ACA sentinel sites project.

  • Web Briefing for Journalists: How ACA’s Employer Requirements and Related Provisions Affect Businesses and Workers

    Event Date:
    Event

    A major piece of the Affordable Care Act will first take effect January 1 when larger employers will be required to offer coverage to their workers or face penalties. How do the penalties work and how are they being phased in? To help reporters understand and cover these issues, the Kaiser Family Foundation held a web briefing exclusively for journalists.

  • Majority Favors the Affordable Care Act’s Employer Mandate, But Opinion Can Shift When Presented With Pros and Cons

    News Release

    Recent news stories on the heath law did not attract most Americans’ attention, and many are unaware of details and implications of the developments Weeks before the Affordable Care Act’s employer mandate takes effect in January, a new Kaiser Family Foundation tracking poll finds that six in 10 Americans (60%) say they have a favorable view of the provision, which in 2015 requires employers with 100 or more full time workers to offer health coverage…

  • Medicaid Expansion in Red States

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explains that Tennessee Gov. Bill Haslam's decision on Medicaid expansion via the Affordable Care Act is the latest sign of pragmatism slowly winning over ideology in red states.