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The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

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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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  • I notice “Catastrophic plans” that look even cheaper than other Marketplace plans. What are those, and can I buy one?

    FAQs

    Catastrophic plans have the highest cost sharing and lowest premiums. In 2026, Catastrophic plans will have an annual deductible of $10,600 for an individual or $21,200 for a family. The plan does not have to cover more than three primary care visits before the deductible has been met. Catastrophic plans may only be sold to certain individuals. See this FAQ for details. Note that if you are eligible for financial assistance on the Marketplace, it…

  • Will people in hurricane- or wildfire-affected areas have more time to sign up for coverage?

    FAQs

    Yes, although the extension is not automatic. In HealthCare.gov states, you must apply for the extra time using an Exceptional Circumstances special enrollment period (SEP). You can apply for this SEP by calling the federal Marketplace call center at 1-800-318-2596. You will have to attest to residing in -- or moving from -- areas affected by a disaster event during an enrollment period you were eligible for. Affected areas are those designated by the Federal…

  • Can I buy a plan in the Marketplace if I don’t have a green card?

    FAQs

    Potentially, yes. You must be a lawfully present immigrant who is eligible for coverage, such as a lawful permanent resident (green card holder), certain types of visa holders, or a refugee or asylee. Deferred Action for Childhood Arrivals (DACA) is no longer considered an eligible immigration status for health coverage through the Marketplaces. You can find more information about qualifying statuses here.   You can also shop for health insurance outside of the Marketplace in…

  • I’m eligible for health benefits at work, but want to see if I can get a better deal on the Marketplace. Can I do that?

    FAQs

    You can always shop for coverage on the Marketplace, assuming you meet other eligibility requirements, but if you have access to job-based coverage that is determined to be affordable (no more than 9.96% of your household income in 2026), you won’t qualify for premium tax credits. Browse more questions in the Employer-Sponsored Health Coverage and the Marketplace section.

  • How can I find out if my doctor is in a health plan’s network?

    FAQs

    Every plan Marketplace plan must provide a link to its health provider directory on the Marketplace website to its health provider directory so consumers can find out if their health care providers are included. The provider network information from insurance companies must also tell you whether a provider is accepting new patients. Some insurers' provider directories may list the languages spoken by providers, but this is not federally required. If your state uses HealthCare.gov (federally-facilitated…

  • What health benefits do Marketplace plans cover?

    FAQs

    All qualified health plans offered in the Marketplace cover the "essential health benefits" (EHB), including: Ambulatory patient services (outpatient care you get without being admitted to a hospital) Emergency services Hospitalization Maternity and newborn care (care before and after your baby is born) Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain…

  • Can I buy or change private health plan coverage outside of Open Enrollment?

    FAQs

    In general, you can have a special enrollment period (SEP) to sign up for Marketplace coverage during the year, other than during Open Enrollment period, if you have a qualifying event. Some examples of qualifying events include marriage, gaining a dependent, or loss of employment. Only one person in a household applying for coverage or financial assistance through the Marketplace must qualify for an SEP in order for the entire household to qualify for the…

  • I bought emergency contraception over-the-counter (OTC) at my pharmacy and thought it would be covered by my insurance, but I ended up having to pay the full cost out-of-pocket. Why wasn’t it cove...

    FAQs

    Emergency contraception is one of the FDA-approved methods for women that must be covered by most health plans, including those sold on the Marketplace, but it has to be prescribed by a health care provider in order for most insurance plans to cover it. If you don’t have a prescription, you will likely have to pay the full cost out-of-pocket. However, you can ask your provider (or pharmacist if your state allows it) for a prescription…