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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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  • Kaiser Health Policy News Index: June 2014

    Feature

    This month's Health Policy News Index finds more than six in 10 say they followed news about long waiting lists for those seeking care at Veterans Affairs (VA) medical facilities closely. That makes the VA story the most closely followed health story in the first half of 2014, with slightly more people following it than followed several ACA enrollment stories earlier this year.

  • What Women Think of the Core Issue in the Hobby Lobby Case

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case. Overall, by a margin of…

  • Legal Analysis of the Supreme Court Ruling on Hobby Lobby

    Feature

    This chart looks at the U.S. Supreme Court decision in the Hobby Lobby case involving the Affordable Care Act's (ACA) contraceptive coverage requirement. It examines how the Court answered four key questions in the case.

  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…

  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion Decisions in the South

    Other Post

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the South remain…

  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion in the South

    News Release

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the…

  • Data Note: Differences In Public Opinion On The ACA’s Contraceptive Coverage Requirement, By Gender, Religion, And Political Party

    Feature

    One of the most politically polarizing elements of the Affordable Care Act (ACA) is the law’s requirement that new private health insurance plans cover prescription contraceptives and services, including all methods approved by the Food and Drug Administration. The rule currently provides an exemption for houses of worship and an “accommodation” for religiously affiliated non-profit employers who object to providing contraceptive coverage; however all for-profit employers that provide health insurance must include this benefit. Over…

  • Health Coverage and Care in the South in 2014 and Beyond

    Issue Brief

    This issue brief provides an overview of health coverage and care in the South today, with a focus on demographics, the impact of the ACA coverage expansions, and ongoing efforts to improve the delivery system and safety net in the South.

  • Advancing Opportunities, Assessing Challenges: Key Themes from a Roundtable Discussion of Health Care and Health Equity in the South

    Issue Brief

    This brief summarizes the primary themes expressed by participants of a roundtable discussion of current and future opportunities and challenges for advancing health care and health equity in the South organized by Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Georgia.