Home Affordable Care Act Topics

Affordable Care Act

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?

Latest News

More KFF Health News

Stay informed.

Get KFF's latest on the Affordable Care Act

Stay informed.

Get KFF's
latest on the Affordable
Care Act

View the Latest: Affordable Care Act

Filter

List Grid

191-200 of 2,788 results

  • What happens if I don’t update my application for financial assistance?

    FAQs

    If you don't update your information with the Marketplace, in most cases, the Marketplace will automatically adjust the amount of your premium tax credit for next year. If that turns out to be less than the amount you’re actually eligible for, you will have to pay more premium each month than you otherwise would have had to, although you can receive a refund for the rest when you file your federal tax return. On the…

  • I like my Marketplace plan just the way it is. Will it stay the same next year?

    FAQs

    It depends. Insurers are allowed to make changes to plans each year. Most likely, the premium for your current policy will change next year. There may be other changes as well such as the deductible or copays. In some cases, an insurer may stop offering a particular plan and offer you new choices, instead. Shortly before Open Enrollment begins, you should receive a notice from your insurance company describing any changes to your plan and…

  • I want to enroll in a Marketplace family plan to cover myself, my spouse, and our children. How will my family premium be calculated?

    FAQs

    Family premiums will reflect the composition of family members; in most states, this includes their ages and any tobacco use. To calculate a “family premium,” insurers will add together a separate premium for each adult age 21 and older. Insurers can charge a separate premium for up to three children under age 21. For example, if you have four children under age 21, your family premium will reflect two adult premiums and only three child…

  • I notice Marketplace plans are labeled “Bronze,” “Silver,” “Gold,” and “Platinum.” What does that mean?

    FAQs

    Plans in the Marketplace are separated into categories — Bronze, Silver, Gold, or Platinum — based on the amount of cost sharing they require. Cost sharing refers to health plan deductibles, copays, and coinsurance. For most covered services, you will have to pay some of the cost, at least until you reach the annual out-of-pocket limit on cost sharing. Preventive health services, however, are covered without cost-sharing. In the Marketplace, Bronze plans have the highest…

  • Do I have to prove eligibility for a special enrollment period?

    FAQs

    Yes, in some cases. When you apply for Marketplace coverage and qualify for a Special Enrollment Period, the Exchange may request additional documents to confirm that you qualify for coverage in your Marketplace Eligibility notice. If you apply for Marketplace coverage following loss of other coverage, HealthCare.gov will let you select a health plan but will delay the effective date of coverage while it verifies your loss of other coverage. If the Marketplace cannot automatically…

  • Who can buy coverage in the Marketplace?

    FAQs

    Most people can shop for coverage in the Marketplace. To be eligible you must live in the state where your Marketplace is, you must be a citizen of the U.S. or be lawfully present in the U.S., you must not currently be incarcerated, and you cannot currently be enrolled in Medicare. Deferred Action for Childhood Arrivals (DACA) is no longer considered an eligible immigration status for health coverage through the Marketplaces. Not everybody who is…

  • Are there special timelines for enrolling in the Marketplace for people who lose Medicaid or CHIP?

    FAQs

    The special enrollment period due to loss of Medicaid or CHIP is 90 days, which means consumers will have up to 90 days after loss of Medicaid or CHIP to enroll in Marketplace coverage. However, state-based Marketplaces have the option to extend the special enrollment period beyond 90 days. Check with your state Marketplace for more information if you live in one of these states.

  • I received a Form 1095-B in the mail. What’s that?

    FAQs

    Health insurance companies, certain employer-sponsored health plans, and public health programs such as Medicaid may provide you with documentation indicating the months during the prior year when you were covered under the plan. Coverage providers may send Form 1095-B directly to you, but in some cases, you may have to request a Form 1095-B from the coverage provider. If you were enrolled in family coverage, Form 1095-B will indicate the names of all family members who were…