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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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  • How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

    Issue Brief

    This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will be wide state variation. The paper presents data showing how states compare in their 2012 Medicaid fee levels, how Medicaid fees compared to Medicare fees,…

  • Poll: Nearly Half of the Public Say They or a Family Member Skipped or Delayed Care Due to Coronavirus, But Most Plan to Get Care in the Coming Months

    News Release

    Nearly One in Four Expect a Family Member to Turn to Medicaid in the Coming Year, and Majorities across Party Lines Oppose Medicaid Cuts to Address State Budget Shortfalls Amid the threat of coronavirus, nearly half (48%) of Americans say someone in their family has skipped or delayed getting some type of medical care due to the pandemic, the latest KFF Health Tracking Poll finds. This includes 11% who say the person’s condition worsened due…

  • Kaiser Health Tracking Poll: Election 2008 — April 2008

    Poll Finding

    An April 2008 poll finds that health care costs rank among Americans’ top personal economic problems, and their struggles to deal with those costs have affected both their financial well-being and their family’s health care.  Conducted by the Foundation’s public opinion researchers, the poll probes into the economic concerns facing Americans and the ways they have dealt with the cost of health care. Across a series of economic concerns, health care costs rank near the…

  • Kaiser Health Tracking Poll: Election 2008 – June 2008

    Poll Finding

    The latest Kaiser Health Tracking Poll: Election 2008 poll finds that the recent economic downturn continues to create serious financial problems for most Americans. When asked about the impact of recent economic changes, nearly six in 10 adults (59 percent) report having a "serious problem" with one of seven major financial issues, including one in four who cite paying for health care as a serious problem. Not surprisingly, with gas prices topping $4 per gallon…

  • Health Care Reform Newsmaker Series: Sen. Chuck Grassley (R-Iowa)

    Event Date:
    Event

    Sen. Chuck Grassley (R-Iowa), ranking Republican member of the Senate Committee on Finance, appeared as a guest in the new series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session.  Transcript (.pdf) Video

  • National Health Insurance — A Brief History Of Reform Efforts In The U.S.

    Issue Brief

    This policy brief provides an overview of health reform efforts in the United States over much of the last century, from New Deal-era calls for government-subsidized health coverage to the creation of Medicare and Medicaid in the 1960s and the failed attempt at universal coverage in the early 1990s. Issue Brief (.pdf)

  • Resources on Community Health Centers

    Fact Sheet

    The Kaiser Family Foundation has issued three new resources that examine the role of community health centers as key components of the U.S. health care system, providing primary care to more than 16 million patients nationwide in 2007. The documents, produced for the Kaiser Commission on Medicaid and the Uninsured, include a fact sheet on community health centers, an updated issue brief on their role in the health system and a report on how such…

  • Health Care Reform Newsmaker Series: Nancy-Ann DeParle, Director of the White House Office of Health Reform

    Event Date:
    Event

    Nancy-Ann DeParle, director of the White House Office of Health Reform, appeared as the third guest in a series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session.  Transcript (.pdf) Video

  • Pulling it Together: The “Third School” for Controlling Health Care Costs?

    Perspective

    For as long as I have been in the field, there have been two dominant schools of thought about how to control health care costs. One school, The Regulators, believed that the best way to slow increasing costs was to control the total resources going into the health care system: putting limits on the supply of medical professionals, technology and facilities; setting payment rates; or putting enough purchasing power in the hands of government to…