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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

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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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  • Obamacare y Usted: Si compra seguro médico en el mercado individual

    Fact Sheet

    Si usted compra su plan de salud por su cuenta (en vez de tener cobertura a través de su empleador), usted tendrá nuevas opciones para tener su cobertura, pero la Ley del Cuidado de Salud a Bajo Precio requiere que usted esté asegurado o será multado. Qué está cubierto Bajo Obamacare, los planes de salud deben cubrir visitas al doctor, hospitalizaciones, recetas de drogas y cuidado materno sin restricciones por condiciones preexistentes, o condiciones físicas…

  • State Marketplace Profiles: Oregon

    Other Post

    Final update made on October 10, 2013 (no further updates will be made)  Establishing the Marketplace On June 17, 2011, Governor John Kitzhaber (D) signed SB 99 into law establishing the Oregon Health Insurance Exchange Corporation.1   That same month, the Governor signed SB 91, which specified requirements of health insurance carriers offering coverage in the state.2  On March 6, 2012, the legislature passed HB 4164 to approve the final version of the Marketplace’s business plan.3 …

  • What’s Trending in Health Care? Conservative Ideas

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

  • Connecting Consumers to Coverage: Lessons Learned from Assisters for Successful Outreach and Enrollment

    Issue Brief

    This brief highlights the experiences of Navigators and other Marketplace consumer assistance programs under the Affordable Care Act (Obamacare) in conducting outreach and providing enrollment assistance during the ACA's first open enrollment period. It provides insight into the outreach and enrollment strategies the assisters developed and identifies the keys to successfully overcoming the challenges of the first year. These insights are based on findings from focus groups with assisters in four cities: Miami, Florida; Houston,…

  • An Overview of Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) Grants

    Issue Brief

    This brief provides an overview of the Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) grants and highlights key findings from the interim evaluation of the program. The brief also places these grants in context of pre-Affordable Care Act (ACA) Medicaid beneficiary incentive programs and proposed programs of states that are incorporating healthy behavior incentives into Medicaid expansion waivers.

  • An Update on Coverage for Preventive Services Under the Affordable Care Act

    News Release

    An updated fact sheet from the Kaiser Family Foundation summarizes the latest information on health plan coverage of preventive services under the Affordable Care Act. The fact sheet details the rules that govern when plans are required to cover services without cost-sharing and which services are covered. In addition, the fact sheet summarizes the clarifications issued by the U.S. Department of Health and Human Services on coverage for a number of services including: colon cancer…

  • Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

    Issue Brief

    This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

  • Helping People With HIV Navigate the Transition to ACA Coverage: Summary of a Roundtable Discussion

    Issue Brief

    In March 2013, the Kaiser Family Foundation convened key HIV/AIDS stakeholders from a variety of backgrounds to explore opportunities for maximizing the beneficial impact of the Affordable Care Act (ACA) for people living with HIV and examine strategies to help them navigate the transition to new health coverage. This report summarizes the information shared and key issues discussed at the meeting.

  • Obamacare and You

    Fact Sheet

    Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people. Click on the links below to learn more: If You Are Uninsured  Haga clic para leer en español  If You Are Low-Income and May Qualify for Medicaid  Haga clic para leer en español If You Have a Pre-Existing Condition Haga clic para leer en español If You Buy Coverage in the Individual Market…