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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 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.

  • 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…