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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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  • Analysis Examines How Gaining Health Coverage Affected Consumers’ Lives in 2014

    News Release

    An analysis of a 2014 survey by the Kaiser Family Foundation finds that previously uninsured Americans who obtained health coverage that year experienced improved access to care and a decrease in financial insecurity, though they remained concerned about cost.  The analysis of the 2014 Kaiser Survey of Low-Income Americans and the ACA finds that about 11 million previously uninsured nonelderly adults obtained health coverage during 2014, the year the ACA’s new coverage options were fully…

  • After King v. Burwell Ruling, Health Law Issues Involve Implementation

    News Release

    After today’s Supreme Court ruling upholding the Affordable Care Act’s federal subsidies, Drew Altman's latest column in The Wall Street Journal's Think Tank explores what the decision means and what’s next for the health law. All previous columns by Drew Altman are available.

  • Poll Finds 62% of Americans Approve of the Supreme Court’s Decision to Continue Allowing ACA Health Insurance Subsidies in All States, While 32% Disapprove

    News Release

    Public’s View of the Health Care Law Remains Nearly Evenly Divided Immediately Following King v. Burwell Ruling Nearly Eight in 10 Americans Expect More Major Battles about the ACA in the Future Just over six in 10 Americans (62%) say they approve of the U.S. Supreme Court’s decision last week to continue allowing low- and moderate-income people in all states to be eligible for government subsidies to buy health plans through Affordable Care Act (ACA)…

  • What a Break in the Obamacare Battles Could Bring

    From Drew Altman

    Following the Supreme Court’s King v. Burwell decision, the Affordable Care Act could use a break from the intense political heat, though it may not get a long one as the 2016 election season heats up and presidential candidates play to their bases on health care, writes Drew Altman in his latest column for The Wall Street Journal’s Think Tank.

  • Takeaways From Alaska’s Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses the implications of the governor of Alaska’s decision to move ahead unilaterally with Medicaid expansion.

  • Survey Finds Many Primary Care Physicians Have Negative Views of the Use of Quality Metrics and Penalties for Unnecessary Hospital Readmissions 

    News Release

    Primary Care Providers View Health IT as Improving Quality, But Tilt Negatively on ACOs Half of the nation's primary care physicians view the increased use of quality-of-care metrics and financial penalties for unnecessary hospitalizations as potentially troubling for patient care, according to a new survey from The Commonwealth Fund and the Kaiser Family Foundation. Fifty percent of primary care physicians say the increased use of quality metrics to assess provider performance is having a negative…

  • New Survey Examines Assistance Provided to Consumers During Second Affordable Care Act Open Enrollment

    News Release

    A new Kaiser Family Foundation survey of insurance brokers and assistance programs examines the help they provided to consumers during the 2015 open enrollment period for Affordable Care Act coverage. The 2015 Survey of Health Insurance Marketplace Assister Programs and Brokers provides estimates of the number of people helped and the number and type of assister programs, while offering an in-depth look at assisters’ assessments of the enrollment process in the second year of the…

  • A Look at the Private Option in Arkansas

    Issue Brief

    Based on stakeholder interviews and early data on coverage, reduced uncompensated care costs, and other topics, this issue brief provides an initial look at implementation of Arkansas' Section 1115 Medicaid expansion demonstration waiver to require most adults newly eligible for Medicaid through the Affordable Care Act's Medicaid expansion to enroll in Marketplace plans.

  • How Many Employers Could be Affected by the Cadillac Plan Tax?

    Issue Brief

    As fall approaches, we can expect to hear more about how employers are adapting their health plans for 2016 open enrollments. One topic likely to garner a good deal of attention is how the Affordable Care Act’s high cost plan tax (HCPT), sometimes called the “Cadillac plan” tax or "Cadillac tax," is affecting employer decisions about their health benefits. The tax takes effect in 2018. The potential of facing an HCPT assessment as soon as…