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.

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

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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  • Children’s Health Coverage: Medicaid, CHIP and the ACA

    Issue Brief

    This brief provides an overview of children’s coverage leading up to the implementation of the Affordable Care Act (ACA), a review of changes for children included in the ACA, and a look at issues leading up to the reauthorization of the CHIP program.

  • Kaiser Health Tracking Poll: March 2014

    Feature

    The March Kaiser Health Tracking Poll finds that the gap between unfavorable and favorable opinions of the ACA narrowed this month among the public and the uninsured, and more want Congress to improve the law than replace it. The survey also finds that six in ten of the uninsured are unaware of the March 31 deadline to sign up for coverage, and half say they plan to remain uninsured.

  • Obamacare: The Metrics In The News Are Mostly Wrong

    From Drew Altman

    In this Policy Insights, Kaiser Family Foundation President and CEO Drew Altman explains how the measures of success for year one of Obamacare used in media coverage and national discussion is the equivalent of judging the local weather from national averages.

  • Visualizing Health Policy: What Americans Pay for Health Insurance Under the ACA

    Other Post

    The March 2014 Visualizing Health Policy infographic shows examples of what Americans will pay for health insurance under the Affordable Care Act, using different scenarios for 40-year-old individuals living in different parts of the country. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). The full-size infographic is freely available on JAMA’s website and is published in the print edition of the journal. >>View source slides

  • Sizing Up Exchange Market Competition

    Issue Brief

    This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and…

  • All Eyes on the Supreme Court: More than Birth Control at Stake

    Issue Brief

    On March 25th, the Supreme Court will hear two cases brought by for-profit corporations challenging the ACA’s contraceptive coverage rule on religious grounds. These two corporations are Hobby Lobby, a national chain of craft stores owned by a Christian family and Conestoga Wood Specialties, a cabinet manufacturer, owned by a Mennonite family. Beyond the impact on the ACA and contraceptive coverage, the Court’s decision may have implications for religious rights of employers and employees, as…