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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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  • Brief Examines the COVID-19 Crisis’ Implications for Americans’ Mental Health

    News Release

    Nearly half (45%) of adults across the country say that worry and stress related to the coronavirus (COVID-19) pandemic are hurting their mental health, an early sign that the health and economic crises is likely to increase mental health problems and further stretch the system’s capacity. A new issue brief explores how the crises and related measures to protect public health, including social distancing, business and school closures, and shelter-in-place orders, are likely to affect…

  • Poll: Most Americans Say President Trump is Intervening with the FDA’s and CDC’s Coronavirus Work, But Trust the Agencies at Least a Fair Amount to Do the Right Thing

    News Release

    As COVID-19 cases rise across much of the country, most Americans think that the president is intervening with the public health agencies working to address the pandemic, the latest KFF Health Tracking Poll finds. Similar majorities say both that President Trump is intervening with the Food and Drug Administration’s efforts to review and approve a coronavirus vaccine (55%) and that he is in intervening with the Centers for Disease Control and Prevention’s efforts to issue coronavirus guidelines…

  • 2020 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2020 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • Web Briefing: The California v. Texas Supreme Court Case and Its Implications for the ACA

    Event Date:
    Event

    On Tuesday, Nov. 10, the Supreme Court will hear oral arguments on a legal challenge supported by the Trump administration that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. KFF held an interactive web briefing on Monday, Nov. 9, to share insights about the legal issues in the case and the potential…

  • Individual Insurance Market Performance in Early 2020

    Issue Brief

    Individual market insurers, on average, remained profitable through the first three months of 2020 as claims costs rose only slightly compared to the same period last year. It is likely that the most significant impacts of the coronavirus on the individual market will not be evident nationally until second or third quarter data are released.

  • The 2020 Presidential Election: Implications for Women’s Health

    Issue Brief

    This brief and side-by-side tables reviews the key health issues that are likely to have a direct impact on women’s health as well as their access to coverage and care, and summarizes the presidential candidates’ stated positions and records on these issues.

  • Kaiser Health Tracking Poll: Election 2008: October 2008

    Poll Finding

    The final Kaiser Health Tracking Poll: Election 2008 finds more people are reporting problems with health care bills, and paying for health care retains a solid hold on the public’s list of their top economic concerns. About one in three Americans now report their family has had problems paying medical bills in the past year, up from about a quarter saying the same two years ago.  Almost one in five (18%) of Americans report household…