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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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  • Providing Outreach and Enrollment Assistance: Lessons Learned from Community Health Centers in Massachusetts

    Issue Brief

    As states and communities gear up to provide outreach and enrollment assistance under the ACA, the enrollment assistance experience of health centers in Massachusetts, where a major expansion of health coverage was implemented six years ago, offers valuable lessons that can help to inform current and emerging efforts by health centers and other community-based organizations to reach and enroll millions of low-income, uninsured Americans in health insurance.

  • Medicaid Expansion Through Marketplace Premium Assistance

    Fact Sheet

    This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

  • Getting into Gear for 2014: An Early Look at Branding and Marketing of New Health Insurance Marketplaces

    Issue Brief

    Based on a review of publicly available materials as of September 2013, this brief provides an examination of the Marketplace branding strategies, websites, and marketing materials, providing insight into how consumers will be introduced to the Marketplaces and some of the key messages and approaches the Marketplaces will utilize to encourage individuals to enroll. As of September 2013, states and the federal government are on the eve of their October 1st launch of open enrollment…

  • How Buying Insurance Will Change Under Obamacare

    Perspective

    When the Affordable Care Act’s (ACA) health insurance marketplaces (also known as “exchanges”) go online this October, millions of people are expected to apply for private insurance coverage. Nobody expects the launch will be perfect, with no hitches and problems.  The law not only replaces a fragmented and confusing assortment of plan options in today’s individual insurance market, but it also integrates tax credits to help people pay their premiums, which requires an entirely new…

  • Kaiser Health Tracking Poll: September 2013

    Feature

    September 2013 Kaiser Health Tracking Poll gauges public opinion on the ACA days before open enrollment for Obamacare health insurance marketplaces begins.

  • Kaiser Family Foundation/NBC News Survey Questions

    Poll Finding

    The Kaiser Family Foundation partnered with NBC News to ask several survey questions of the U.S. public about their feelings towards the 2010 health care law, as well as their worries about affording health care more generally. These questions were asked as part of the September 2013 Kaiser Health Tracking Poll. Kaiser Family Foundation/NBC News Survey Topline Download

  • Obamacare y usted

    Fact Sheet

    "Obamacare y usted" es una serie de materiales que explican cómo la Ley de Cuidado de Salud a (Affordable Care Act o ACA en inglés), también llamada “Obamacare,” afecta a diferentes grupos de personas. Haga clic en los links de abajo para aprender más: Si no tienes seguro médico Haga clic para leer en inglés / Click here to read this fact sheet in English Si tienes bajos ingresos y puede calificar para Medicaid Haga clic…

  • Who Will be the H&R Block and TurboTax for Health Insurance?

    Perspective

    There's been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as "producers"). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that would exempt agent and broker commissions for health insurance from minimum medical loss ratio (MLR) thresholds established in the health reform law. (The MLR is…