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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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  • Visualizing Health Policy: Eligibility and Coverage Trends in Employer-Sponsored Health Insurance

    Other Post

    This Visualizing Health Policy infographic looks at eligibility and coverage trends in employer-sponsored health insurance. Between 2000 and 2015, the share of workers covered by health benefits offered by their employers dropped from 63 percent to 56 percent, with some firms not offering coverage and some employees not enrolling when coverage is offered. The biggest decrease occurred among employees working for small firms (3-199 workers). Among people younger than 65, those with lower incomes continued to…

  • The ACA and People with HIV: An Update

    Issue Brief

    This report provides a second look at how the Affordable Care Act (ACA) is impacting people with HIV two years into these new coverage opportunities, based on focus groups conducted with HIV positive individuals from five states in early 2016, after the third round of open enrollment. Groups were conducted with HIV positive individuals who gained insurance coverage – through either the Marketplaces or Medicaid expansion- in California and New York and with those who…

  • People with HIV Who Gained Health Coverage Under ACA Are More Comfortable Navigating Insurance Two Years Later, But Problems Persist, Others Remain Uninsured

    News Release

    A new Kaiser Family Foundation report based on focus groups conducted in five states finds people living with HIV are more comfortable with navigating health insurance two years into the Affordable Care Act’s (ACA) major coverage expansions. Those in the marketplaces and Medicaid recognize their new benefits but often continue to worry about maintaining coverage and remain concerned about its affordability, and many in states without Medicaid expansion remain uninsured. The brief takes a second…

  • Partisanship’s Grip On The Affordable Care Act

    From Drew Altman

    In this Wall Street Journal's Think Tank column Drew Altman analyzes data from an upcoming Kaiser poll and discusses how partisanship is the dominant factor shaping views of the Affordable Care Act for Republicans and Democrats enrolled in marketplace plans.

  • Survey Finds Most Marketplace Enrollees Like Their Coverage, Though Satisfaction with Premiums and Deductibles Has Declined Since 2014

    News Release

    Following the Affordable Care Act’s (ACA) third open enrollment period, a new Kaiser Family Foundation survey of people who buy their own health insurance finds most marketplace enrollees give their coverage good marks, though concerns about premiums, deductibles, and other costs have risen since 2014. The survey, the third in a series, finds about two thirds (68%) of marketplace customers rate their current coverage as either “excellent” or “good.” Although concerns about narrow network plans…

  • Puerto Rico: Datos Básicos

    Fact Sheet

    Puerto Rico: Datos Básicos provee una descripción general del las características demográficas, y estadísticas de salud y la economía. También se da alguna informacion del gobierno, reglas federales de Medicaid, y asuntos corrientes que estan afectando el territorio, incluyendo a Zika.