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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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  • Obamacare y Usted: Si compra seguro médico en el mercado individual

    Fact Sheet

    Si usted compra su plan de salud por su cuenta (en vez de tener cobertura a través de su empleador), usted tendrá nuevas opciones para tener su cobertura, pero la Ley del Cuidado de Salud a Bajo Precio requiere que usted esté asegurado o será multado. Qué está cubierto Bajo Obamacare, los planes de salud deben cubrir visitas al doctor, hospitalizaciones, recetas de drogas y cuidado materno sin restricciones por condiciones preexistentes, o condiciones físicas…

  • Obamacare y Usted: Si tiene bajos ingresos y puede calificar para Medicaid

    Fact Sheet

    Obamacare crea muchas formas de obtener cobertura de salud. Usted puede aprender sobre sus opciones llenando una única aplicación. Así, se le dirá si califica para cobertura gratis o a bajo costo a través del programa Medicaid, o a través de los nuevos Mercados de Seguros Médicos que han sido establecidos en cada estado. Usted debería aplicar para cobertura aunque en el pasado no haya tenido la capacidad de tenerla a través del Medicaid o…

  • Obamacare y Usted: Si no tiene seguro médico

    Fact Sheet

    Obamacare ha creado nuevas maneras de tener cobertura de salud. Si usted no tiene seguro médico a través de su empleador, seguramente pueda obtenerlo a través del nuevo Mercado de los Seguros Médicos (o "intercambio") en su estado. Nuevas opciones de cobertura Llenando una única aplicación, usted aprenderá sobre sus opciones de planes médicos y los costos, y si califica para tener cobertura a través de Medicaid o para recibir un subsidio para comprar un…

  • State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act

    Issue Brief

    Key provisions of the 2010 Affordable Care Act (ACA) create new Marketplaces for people who purchase insurance directly and provide new premium tax credits to help people with low or moderate incomes afford that coverage. This analysis estimates that about 17 million people who are now uninsured or who buy insurance on their own (“nongroup purchasers”) will be eligible for premium tax credits in 2014. This issue brief provides national and state estimates for tax…

  • Implications of the Affordable Care Act for People With HIV Infection and the Ryan White HIV/AIDS Program: What Does the Future Hold?

    Issue Brief

    There are numerous aspects of the Affordable Care Act that will be important for people with HIV in the U.S., -- however, it is unlikely that these changes will address all the needs of people with HIV. The Ryan White HIV/AIDS Program will thus remain crucial for the provision of adequate health care to HIV-infected individuals, but it will need to change. Changes in the Ryan White Program’s role will depend largely on state decisions…

  • State Marketplace Profiles: New Mexico

    Other Post

    Final update made on October 25, 2013 (no further updates will be made) Establishing the Marketplace On March 28, 2013, Governor Susana Martinez (R) signed legislation creating the New Mexico Health Insurance Exchange (NMHIX). Governor Martinez had vetoed previous legislation that would have established a Marketplacein 2011; however, the state had moved forward with a plan to create the New Mexico Health Insurance Exchange within the New Mexico Health Insurance Alliance.1  The Alliance was created…

  • Obamacare Vital Signs Not Just Numbers

    From Drew Altman

    In his latest column, Kaiser President and CEO Drew Altman discusses the focus on first year metrics, especially enrollment projections, in the ACA debate.

  • State Marketplace Profiles: West Virginia

    Other Post

    Final update made on October 24, 2013 (no further updates will be made) Establishing the Marketplace On February 15, 2013, Governor Earl Ray Tomblin (D) submitted a blueprint to Secretary Sebelius for West Virginia to establish a Partnership Marketplace with plan management responsibilities.1  In the previous year, Governor Tomblin had signed SB 408 into law to establish the West Virginia Health Benefits Exchange and the state had begun exploring implementation options for a state-based marketplace.…