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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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  • It’s Not Obamacare Anymore. It’s Our National Health-Care System.

    From Drew Altman

    In this Washington Post op-ed, Drew Altman and Larry Levitt discuss why the latest Republican effort to repeal and replace the Affordable Care Act failed and what it will take for congress and the administration to address the next challenge, providing long-term stability to the ACA marketplaces.

  • How the Elections Could Put the Brakes on Anti-ACA Plans

    From Drew Altman

    In this Axios column, Drew Altman examines the role of health care in Virginia's elections and the referendum on Medicaid expansion in Maine. His assessment: the elections and the referendum will have a bigger impact on upcoming policy debates about cutting Medicaid to pay for tax cuts, and state interest in Medicaid expansion, than on upcoming elections. 

  • Poll: Half of the Public Would Blame the Trump Administration if Fewer People Enroll in Marketplace Plans This Year, and Most See President Trump and Republicans As Responsible for the ACA‘s Future 

    News Release

    Majorities of Democrats, Independents and Republicans Would Support Allowing People Younger Than Age 65 to Buy into Medicare Half (50%) of the public would say that if fewer people sign up for marketplace plans during this year’s open enrollment, it is mainly due to the Trump Administration, and most Americans (61%) see President Trump and Republicans as responsible for the Affordable Care Act’s future, the latest Kaiser Family Foundation poll finds. While the public generally…

  • Kaiser Health Tracking Poll – September 2017: What’s Next for Health Care?

    Feature

    This poll finds large majorities across all parties say reauthorizing funding for the Children's Health Insurance Program (CHIP) is an important priority for Congress; however, a larger share of Republicans also say it is important for Congress to work on repealing and replacing the Affordable Care Act (also known as Obamacare). This month's Kaiser Health Tracking Poll also examines public support for a variety of competing health care policies aimed at improving or replacing the…

  • Public Ranks Children’s Health Insurance, Marketplace Stabilization Higher Priorities than ACA Repeal

    News Release

    Majorities Support Buy-In Ideas for Medicaid and Medicare Among health priorities facing urgent deadlines in Washington in September, the public ranks repeal of the Affordable Care Act lower than reauthorizing funding for the Children’s Health Insurance Program (CHIP) and stabilizing individual health insurance marketplaces established by the ACA, the Kaiser Family Foundation’s new tracking poll finds. About seven in 10 Americans -- and majorities across parties -- say it’s “extremely” or “very” important to reauthorize…

  • The Republican Health-care Plan the Country Isn’t Debating

    From Drew Altman

    In this Washington Post op-ed, Drew Altman discusses how Republicans' ideas to change Medicaid and Medicare and repeal the Affordable Care Act would fundamentally change the federal role in health, calling it: the biggest change in health we are NOT debating.

  • In Focus: Listening to Enrollees with Affordable Care Act Coverage Who Voted for Trump

    News Release

    As Republicans in Washington pursue efforts to repeal and replace the Affordable Care Act, what do enrollees in ACA marketplaces and state Medicaid expansions who voted for President Trump want in a health care plan? The Kaiser Family Foundation asked some of them in six focus groups convened in December in Michigan, Ohio, and Pennsylvania -- three with Trump voters enrolled in the ACA marketplaces and three with Trump voters in Medicaid. Focus group participants…