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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • Those Long Lines To Enroll In The ACA

    News Release

    In the latest post from the series Policy Insights, Kaiser Family Foundation President and CEO Drew Altman discusses the need for community based outreach to enroll the long term uninsured. All previous Policy Insights posts are archived online. The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people. The Foundation…

  • The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities

    Issue Brief

    Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.

  • Those Long Lines To Enroll In The ACA

    From Drew Altman

    In this Policy Insight, Kaiser Family Foundation President and CEO Drew Altman discusses the need for community based outreach to enroll the long term uninsured.

  • How Will the Uninsured Fare Under the Affordable Care Act?

    Fact Sheet

    This report explains how the ACA expands coverage nationally, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people are eligible for Medicaid or financial assistance in the Marketplace. For states…

  • State Fiscal Conditions and Medicaid: 2014 Update

    Issue Brief

    This issue brief provides an overview of Medicaid financing, Medicaid’s role in state budgets, the relationship between Medicaid and the economy and how the ACA and the Medicaid expansion could affect state budgets.

  • A Tale of Two Siblings, the ACA, and the Supreme Court

    From Drew Altman

    In a column published on The Huffington Post, Kaiser Family Foundation President and CEO Drew Altman shows how the U.S. Supreme Court’s decision to make the ACA Medicaid expansion a state option has upended the health insurance system for low and moderate income people in many states and discusses how the states and federal government can address the problem.

  • How Will the Uninsured in New Hampshire Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in New Hampshire, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in New Hampshire are eligible for Medicaid or financial…

  • Kaiser Health Policy News Index: March 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month’s Index finds that the public followed the missing Malaysia Airlines flight and the conflict between Ukraine and Russia more closely than news about ACA enrollment. Additionally, many Americans remain unaware of the status of Medicaid expansion…

  • How Much Financial Assistance Are People Receiving Under the Affordable Care Act?

    Issue Brief

    This analysis examines the amount of financial assistance that people have qualified for through premium tax credits in the new health insurance marketplaces (also known as exchanges) under the Affordable Care Act through the end of February 2014. The brief also examines the implications that the enrollment variation carries for the potential tax benefits the Affordable Care Act offers to state residents.