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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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  • The Affordable Care Act in California: Briefing and Panel Discussion

    Event Date:
    Event

    In the first of many events to highlight Affordable Care Act (ACA) implementation in the states and on the front lines across the country, the Kaiser Family Foundation partnered with the Blue Shield of California Foundation to examine ACA implementation in California (CA) at a Washington, D.C., briefing and panel discussion on February 19, 2014. State and county officials, experts and advocates discussed the latest developments and lessons learned about the ACA implementation in California, a…

  • Webinar for Journalists: Women’s Health Under the Affordable Care Act

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    Event

    The Kaiser Family Foundation hosted an interactive webinar for journalists through its Media Fellowships Program: "Women's Health Under the Affordable Care Act," which took place on Thursday, February 6 from 12:30 p.m. to 1:30 p.m. ET. Now that the ACA's coverage expansions are in effect, the Foundation's latest webinar looked at how the law affects women's access to health coverage and care. The Kaiser Family Foundation's Alina Salganicoff, Vice President and Director of Women's Health Policy, and…

  • Kaiser Health Policy News Index: January 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 looks at the public’s attention to the ongoing rollout of the Affordable Care Act (ACA), as well as other news stories including the release of a major government study on health care costs.

  • Kaiser Health Tracking Poll: January 2014

    Feature

    With enrollment in new coverage options underway, a majority of the public believes that only “some” of the ACA’s provisions have been put into place, while just about one in five think “most” or “all” of the law has been implemented. Awareness of the law’s individual mandate and health insurance exchanges has increased slightly since last year, but about four in ten of the public overall and half the uninsured remain unaware of other major…

  • Medicaid Enrollment Under the Affordable Care Act: Understanding the Numbers

    Issue Brief

    This issue brief walks through data recently released from Health and Human Services (HHS) and what it can and cannot tell us about the number of people that have applied for Medicaid since open enrollment for health insurance marketplaces began, how many have enrolled, and what the role of the ACA is in recent Medicaid coverage gains.

  • Annual Change in Medicaid Enrollment in 50 States and DC, June 2000 to June 2011

    Medicaid Enrollment: June 2013 Data Snapshot

    Issue Brief

    This Data Snapshot provides 50-state data on Medicaid monthly enrollment trends, adding June 2013 data. Overall, Medicaid enrollment growth continued to slow to the lowest rate since the start of the Great Recession as the economic conditions continued to slowly improve. While enrollment growth rates have been trending downward as economic conditions continue to slowly improve, enrollment growth is expected to increase significantly as states implement the ACA. Regardless of whether states decide to implement…