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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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  • The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs

    Report

    The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015.…

  • More Than Four in Ten Uninsured Don’t Know Basic Health Insurance Terms, Fewer Understand Complex Coverage Concepts

    News Release

    Kaiser Family Foundation Provides Consumer Resources to Fill Knowledge Gaps as the Second Open Enrollment Period Nears for the Affordable Care Act’s Marketplaces With open enrollment for the Affordable Care Act’s health insurance marketplaces days away, findings from a new Kaiser Family Foundation survey suggest that some people who stand to benefit from the law struggle to understand how coverage works. The survey finds more than four in 10 uninsured people could not correctly identify…

  • Change in Benchmark Silver Premiums, 2014 – 2015

    Feature

    Change in Benchmark Silver Premiums 2015 MAP_HI_and_MA.ppt Download Source Kaiser Family Foundation analysis of data from Healthcare.gov and insurer rate filings to state regulators. For more information see  “Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces” Sept. 2014.

  • Challenges to Forecasting Obamacare Enrollment for 2015

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why 2015 enrollment in the Affordable Care Act’s marketplaces is very hard to predict. All previous columns by Drew Altman are available online.

  • An Early Look at the Affordable Care Act and Women

    News Release

    On Thursday, May 15 at 9:30 a.m. ET, the Kaiser Family Foundation will host a public briefing to release a new report based on the Foundation’s most recent comprehensive survey on women’s health.  This report provides new findings that will be critical to understanding women’s early experiences with the coverage changes that are part of the Affordable Care Act, including the latest information on:  Private and public insurance coverage rates for women  Use of preventive…

  • New Survey Documents Women’s Health Care, Coverage and Early Experiences with the Affordable Care Act

    News Release

    A comprehensive survey released today by the Kaiser Family Foundation provides a snapshot of women and their health coverage and care during a time of transition as important Affordable Care Act insurance market changes began to take root.   These include many changes that affect women including a prohibition on using gender in setting premiums, as well as broadening access to a more comprehensive range of preventive services benefits without cost sharing. The Kaiser Women’s Health…

  • Avoiding the Wrong Lessons From the VA and HealthCare.gov Problems

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on May 27, 2014. Problems with the launch of HealthCare.gov and with veterans hospitals allegedly concealing long waits for care feed a narrative that government doesn’t work. But many government programs, including Medicare and Social Security, work well. And there are as many examples of corporate bungling–GM and its ignition switches, BP in the Gulf–as there are of government bungling. One impulse when government fails is to…

  • Kaiser Health Policy News Index: May 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 news about the Affordable Care Act (ACA) enrollment numbers was followed by more than half the public, ranking behind two non-health news stories (the kidnapping of Nigerian schoolgirls and the ongoing conflict between…

  • What’s Driving the GOP Health Plan

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on May 30, 2014. Conservative House Republicans are pushing for a vote on a GOP health-care plan, presumably to appeal to their base, to give GOP candidates health reform ideas to talk about on the campaign trail and to show that they have a policy position beyond repealing the Affordable Care Act. Polling shows they have a ways to go. The Kaiser Family Foundation’s May tracking poll…

  • The Washington State Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and health care delivery in Washington under the Affordable Care Act (ACA).