Affordable Care Act

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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  • New Interactive Map Offers State Data on What Democratic Primary Voters Say About Health Care

    News Release

    Democratic voters across the primary states that have already cast their ballots for the 2020 Democratic presidential nomination consistently name health care as the top issue or among the top issues in this year’s election. A new interactive map highlights what Democratic primary voters are saying about health care as they vote. Based on KFF’s analysis of the state-level AP VoteCast data collected in most states as they hold their primary elections, health care ranked…

  • Kaiser Health Tracking Poll: March 2016

    Feature

    The March Kaiser Health Tracking Poll finds that health care is one of many issues that will be important to voters in the Presidential election, trailing concerns about the economy and jobs but leading concerns about immigration. Health care ranks higher for Democratic voters than for Republican and independent voters and is a higher priority for women than for men. Health care costs remain on the forefront of the minds of both the uninsured and…

  • Health and Health Coverage in the South: A Data Update

    Issue Brief

    This brief provides key data on the South and the current status of health and health coverage in the South to provide greater insight into the health needs in the region and the potential coverage gains that may be achieved through the ACA. It includes data on the uninsured, Medicaid expansion and eligibility for coverage.

  • The Role of Medicaid in State Economies and the ACA

    Issue Brief

    This brief summarizes findings from 32 studies in 26 states analyzing the anticipated impact of the Affordable Care Act Medicaid expansion (and in some cases full ACA implementation) on state and local economies.

  • State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act

    Issue Brief

    Key provisions of the 2010 Affordable Care Act (ACA) create new Marketplaces for people who purchase insurance directly and provide new premium tax credits to help people with low or moderate incomes afford that coverage. This analysis estimates that about 17 million people who are now uninsured or who buy insurance on their own (“nongroup purchasers”) will be eligible for premium tax credits in 2014. This issue brief provides national and state estimates for tax…

  • Kaiser Health Tracking Poll — July 2010

    Feature

    The July Health Tracking Poll indicates overall public support for the health reform law is steady from June, while unfavorable views of the law have trended downward.  Half the public (50%) now expresses a favorable view of the law, while 35 percent say they have an unfavorable opinion (down from 41% in June). The poll also took a closer look at the views of seniors since they are often assumed to have a uniform view…

  • Americans Remain Divided Over Health Reform With An Uptick In Public Opposition As GOP Ramped Up Repeal Campaign

    News Release

    As Many Americans Would Like To Keep or Expand Health Reform Law As Would Like To Repeal Or Replace It, And Most Oppose Defunding Implementation Public Concerned About The Deficit But A Majority Opposes Cutting Medicare And Social Security And Nearly Half Are Against Cutting Medicaid WASHINGTON - Though the public remains divided on health reform overall, opposition to the new law ticked upward in January as Republicans ramped up efforts to repeal it, according…

  • Kaiser Health Tracking Poll: February 2013

    Feature

    The February Kaiser Health Tracking Poll focuses on some of the health policy implications of this winter’s national debate over gun violence, gun control and the adequacy of the nation’s response to the needs of those living with serious mental illness. The survey finds that one in five Americans have some connection to a victim of gun violence, a share that doubles to 42 percent among blacks.