Home Affordable Care Act Topics

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?

Latest News

More KFF Health News

Stay informed.

Get KFF's latest on the Affordable Care Act

Stay informed.

Get KFF's
latest on the Affordable
Care Act

View the Latest: Affordable Care Act

Filter

List Grid

181 - 190 of 2,787 Results

  • What is Form 8962?

    FAQs

    If you received an advanced premium tax credit (APTC) through the Marketplace last year, you must file a Form 8962 with your federal income tax return in order to "reconcile" your estimated and actual income for the year, even if you estimated your income perfectly. You can get a blank Form 8962 from the IRS website, or, if you use tax preparation software, the form will be automatically generated for you. The instructions for Form…

  • What happens if I’m late with a monthly health insurance premium payment?

    FAQs

    It depends on whether you are receiving advanced premium tax credits. If you receive a premium tax credit, your insurer must provide a 90-day grace period to pay all past-due premiums. If the amount owed for all outstanding premium payments is not paid in full by the end of the grace period, the insurer can terminate coverage. However, the grace period only applies if you have paid at least one month’s premium within the current…

  • I’ve picked the plan I want. What do I do next, and where do I send my premium payments?

    FAQs

    Your enrollment in the health plan is not complete until the insurance company receives your first premium payment. Once you’ve selected your plan, the Marketplace will direct you to your insurance company’s website to make the first premium payment. In most states, you will make your premium payments directly to the health insurance company. Insurance companies must accept different forms of payment, including for those who do not have a credit card or bank account.…

  • 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…

  • I have COBRA, but it’s too expensive. Can I drop it during Marketplace Open Enrollment and enroll in a Marketplace plan instead?

    FAQs

    During Marketplace Open Enrollment, you can sign up for a Marketplace plan even if you already have COBRA. You will have to drop your COBRA coverage effective on the date your new Marketplace plan coverage begins. After Marketplace Open Enrollment ends, however, if you voluntarily drop your COBRA coverage or stop paying premiums, you will not be eligible for a special enrollment opportunity to enroll in a Marketplace plan and will have to wait until…

  • 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 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…

  • I heard the Affordable Care Act’s individual mandate ended. Does it still make sense to sign up?

    FAQs

    While there is no longer a federal tax penalty for being uninsured, some states (CA, MA, NJ, and RI) and DC have enacted individual mandates and may apply a state tax penalty if you lack health coverage for the year. Regardless of any tax penalty, it is still important to have insurance coverage to help reduce the risk of large medical bills if you get sick, to pay for medications, and to pay for check-ups…

  • I heard that health plans sold on the Marketplace no longer have to cover certain preventive services. Is that true?

    FAQs

    No, this is not true. Health plans sold on the Marketplace are still required to cover certain preventive services without any patient cost sharing. The categories of preventive services Marketplace plans must cover are: Evidence-based screenings and counseling Routine immunizations Childhood preventive services Preventive services for women Click here for more information on covered preventive services.

  • I’m unemployed, and even with UI benefits, I think my 2021 income will be less than the poverty level ($12,760 for a single person in 2021). Can I qualify for marketplace subsidies?

    FAQs

    Yes.  Generally, people must have an annual income at least as high as the federal poverty level in order to qualify for marketplace subsidies.  In states that have not expanded Medicaid eligibility, that leaves poor adults with no access to financial help for health coverage.  However, during 2021 only, people who receive UI benefits during the year and who live in non-expansion states can receive a premium tax credit and cost-sharing subsidies even if their…