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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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  • New Tracker Monitors Affordable Care Act Preventive Services Coverage

    News Release

    The Affordable Care Act requires private insurance plans to cover recommended preventive services with no out-of-pocket charges for patients. This slate of covered services can change when the U.S. Preventive Services Task Force and other authorized groups add or modify recommendations; the federal government also periodically issues clarifications to guide health plans in their coverage. A new tracker from the Kaiser Family Foundation monitors the preventive services that must be covered for adults without cost sharing,…

  • Analysis of 2016 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

    Fact Sheet

    The chart and tables below present an updated analysis of changes in premiums for the lowest- and second-lowest cost silver Affordable Care Act (ACA) marketplace plans in major cities in 48 states and the District of Columbia, where we were able to find complete data on rates for all insurers. This page will be updated as complete rate information becomes available for more states. More background can be found in our earlier analysis of 2016…

  • Opportunities and Resources to Expand Enrollment During the Pandemic and Beyond

    Issue Brief

    This analysis summarizes recent interviews with marketplace navigators and other consumer assistance professionals, who offered observations about the 2021 Open Enrollment period, discussed general and pandemic-specific challenges facing consumers seeking coverage, and offered suggestions to improve enrollment outcomes. The brief also reviews information about federal marketplace resources and spending priorities contained in Trump Administration budget documents, and possible sources of funding for a COVID-19 special enrollment period during the Biden administration. 

  • How the COVID-19 Pandemic is Affecting People’s Mental Health and Substance Use

    News Release

    Throughout the COVID-19 pandemic and resulting economic crisis, about 4 in 10 adults nationwide have reported symptoms of anxiety or depressive disorder – a four-fold increase from pre-pandemic levels. Drawing on the latest national survey data, KFF polling and other research, an updated brief explores what’s known about the pandemic’s impact on people’s mental health and substance use and its implications for Americans’ well-being. Among the key conclusions:   • Young adults have been especially…

  • What to Expect During the COVID Marketplace Enrollment Period

    Policy Watch

    This post provides details about the ongoing Special Enrollment Period to sign up for health coverage on the ACA exchanges, including who is eligible to enroll, how costly Marketplace insurance is on average, and what other factors will affect enrollment during this period.

  • I hear there is a special enrollment opportunity for people with very low income. How does that work?

    FAQs

    Starting August 25, 2025, the special enrollment opportunity that allowed individuals with incomes at or below 150% of the federal poverty level to sign up for Marketplace coverage year-round --simply due to their low income --was eliminated. Individuals at this income level might still qualify for special enrollment under other special enrollment events, such as when they lose coverage due to job loss or lose Medicaid coverage.

  • Large Majorities Across Parties Favor Allowing the Federal Government to Negotiate Drug Prices, Even After Hearing Common Arguments About It

    News Release

    Most of the Public Lacks Confidence that President Biden, Congressional Democrats or Republicans Will Do the Right Thing on Drug Prices Allowing the federal government to negotiate with drug companies to lower drug prices for Medicare beneficiaries and people enrolled in private plans – a key cost-saving proposal in the Democrats’ massive reconciliation bill – is favored by large majorities across political partisans, even after they hear arguments from both sides, a new KFF Health…

  • ¿Puede mi iglesia (o un familiar o tercera parte) pagar mi parte de la prima mensual de mi seguro por mí?

    FAQs

    Familiares pueden realizar pagos de primas y costos compartidos en nombre de los afiliados por el Programa Ryan White de VIH/SIDA, otros programas gubernamentales federales y estatales que brindan apoyo para primas y costos compartidos para personas específicas, naciones u organizaciones nativas. Las reglas federales disuaden a los planes del mercado de aceptar pagos de terceros de hospitales, otros proveedores de atención médica y otras entidades comerciales. Consulte con su plan de salud para obtener…