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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  • What’s Trending in Health Care? Conservative Ideas

    News Release

    What’s Trending in Health Care? Conservative Ideas In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system. All previous columns by Drew Altman are available online.

  • What’s Trending in Health Care? Conservative Ideas

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

  • National Survey Finds 10.6 Million People Helped By Navigators and Assisters During the Affordable Care Act’s First Open Enrollment Period

    News Release

    An estimated 10.6 million people nationally received personal help from navigators and assisters during the Affordable Care Act's first open enrollment period, finds a new Kaiser Family Foundation survey of navigators and assister programs nationally. The survey estimates that the 4,400 assister programs operating nationally had an estimated 28,000 full-time staff and volunteers, suggesting each assister would have helped more than 370 people on average during the six-month open enrollment period that ran from October…

  • Survey of Health Insurance Marketplace Assister Programs

    Report

    This survey by the Kaiser Family Foundation of Navigators and other Marketplace consumer assistance programs under the Affordable Care Act (Obamacare) offers a nationwide analysis of the number and distribution of assisters and people they helped. The report examines the experience of programs in conducting outreach and enrollment assistance during the first open enrollment period. It also reviews the nature of help consumers needed applying for Medicaid or premium tax credits and understanding health insurance…

  • Why the Political Heat on the ACA Is Cooling

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores some early indicators that the political waters may be calming for the Affordable Care Act.

  • Workers Wary of Wellness Programs that Tie Premiums to Participation and Outcomes

    News Release

    June Poll Finds No Change in Public's Overall View of the Affordable Care Act Most in Military Households Say VA Problems Are Systemic and Care Not As Good As What Other Americans Receive  As many employers begin to expand their wellness programs under new guidelines set forth by the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds workers oppose programs that make them pay higher premiums if they fail to participate or…

  • Kaiser Health Tracking Poll: June 2014

    Feature

    As many employers begin to expand their wellness programs under new guidelines set forth by the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds workers oppose programs that make them pay higher premiums if they fail to participate or meet specific health goals. Overall public opinion of the ACA remains about the same as it has for the last several months, with a somewhat higher share of the public continuing to express…