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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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  • Kaiser Health Policy News Index: July 2014

    Feature

    The July Kaiser Health Policy News Index finds the most closely followed news stories this month were discussions about how to deal with large numbers of unaccompanied minors arriving in the U.S. from Central America, military and political conflict between Israel and Hamas, and ongoing problems related to Veterans Affairs (or V.A.) medical facilities. Six in ten report closely following the Supreme Court’s decision in a case about whether for-profit companies should be required to…

  • The Potential Side Effects of Halbig

    Perspective

    The Halbig case, if it prevails, would have far-reaching side effects on the Affordable Care Act’s employer mandate and the functioning of the individual insurance market.

  • Drew Altman: Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act. All previous columns by Drew Altman are available online. 

  • Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act.

  • Survey Finds Approximately 3.4 Million Previously Uninsured Adult Californians Obtained Coverage Since Start of the Affordable Care Act’s First Open Enrollment Period

    News Release

    Immigration Status and Fears Pose Challenges to Further Expanding Coverage Among Hispanics Affordability Key Obstacle to Enrollment for Those Who Remain Uninsured MENLO PARK, Calif. -- Nearly six in 10 (58%) previously uninsured Californians report getting health insurance since last summer, finds the second wave of the Kaiser Family Foundation's Longitudinal Panel Survey following the experiences of a randomly selected  panel of uninsured Californians under the Affordable Care Act (ACA). Based on official estimates of…

  • Where are California’s Uninsured Now? Wave 2 of the Kaiser Family Foundation California Longitudinal Panel Survey

    Report

    This second wave of the Kaiser Family Foundation's California uninsured survey assesses the impact of the Affordable Care Act to date on state residents who were uninsured prior to open enrollment. The results capture the share of previously uninsured Californians who gained coverage or remained uninsured, how they feel about and interact with their new coverage options and what barriers to getting insurance remain. The report examines breakouts by race, coverage type, and other demographic…

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    Event Date:
    Event

    On Monday, July 28, the Kaiser Family Foundation held an interactive web briefing to examine the experiences and lessons of four states -- Colorado, Connecticut, Kentucky, and Washington -- that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA.  The briefing drew upon a new issue brief released today by the Foundation’s Kaiser Commission on Medicaid and the Uninsured (KCMU), What Worked and…

  • The Stakes Beyond the Halbig Lawsuit

    From Drew Altman

    In a column for The Wall Street Journal’s Think Tank, Drew Altman discusses if the legal court cases about whether the government can provide tax credits to people in the Affordable Care Act’s federal health exchanges will be perceived by the American people as a legitimate legal question or as more inside-Washington politics.

  • How Obamacare’s Progress Makes Expanding Coverage Harder

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on July 21, 2014. The Affordable Care Act’s success meeting its initial enrollment goals and the repair of HealthCare.gov seem to have calmed the political waters for Obamacare. But the job of enrolling the uninsured gets harder, not easier, because the remaining uninsured will generally be tougher to reach. Recent surveys show, roughly in line with expectations, that 8 million to 9.5 million fewer adults are uninsured compared with last year before…