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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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 and You

    Fact Sheet

    Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people. Click on the links below to learn more: If You Are Uninsured  Haga clic para leer en español  If You Are Low-Income and May Qualify for Medicaid  Haga clic para leer en español If You Have a Pre-Existing Condition Haga clic para leer en español If You Buy Coverage in the Individual Market…

  • No Quick Verdict on Obamacare

    From Drew Altman

    This column originally appeared in Politico on September 30. Dr. Altman's future Politico columns will be posted on kff.org one day after publication. October 1, the focus of great attention in the Obamacare wars, is finally here. Today is the day open enrollment begins for the new health insurance marketplaces, where Americans can log on and sign up for coverage. The media, opponents, and proponents have been gearing up for a big day — or,…

  • Kaiser Family Foundation/NBC News Survey Questions

    Poll Finding

    The Kaiser Family Foundation partnered with NBC News to ask several survey questions of the U.S. public about their feelings towards the 2010 health care law, as well as their worries about affording health care more generally. These questions were asked as part of the September 2013 Kaiser Health Tracking Poll. Kaiser Family Foundation/NBC News Survey Topline Download

  • Kaiser Health Tracking Poll: September 2013

    Feature

    September 2013 Kaiser Health Tracking Poll gauges public opinion on the ACA days before open enrollment for Obamacare health insurance marketplaces begins.

  • How Obamacare May Be Holding Down Costs

    From Drew Altman

    In his latest column published in Politico, Kaiser President and CEO Drew Altman examines the recent historic slowdown in health-care costs and discusses whether Obamacare is a contributing factor.

  • First Wave of Major New Survey Project on California’s Uninsured

    News Release

    California’s Uninsured Struggle With Costs and Access And Say They Want Insurance, But Most Have Heard Little About The Affordable Care Act, And Many Who Are Likely To Be Eligible For Medi-Cal or Exchange Subsidies Don’t Know It Many Undocumented Immigrants in CA Think They Will Get Coverage Through the ACA But Won’t Menlo Park, Calif. – California’s uninsured are skipping medical care, struggling with costs and want coverage, but many report knowing little about…

  • California’s Uninsured on the Eve of ACA Open Enrollment

    Report

    This report presents the findings of a baseline survey of California’s uninsured adult population just before the start of the first open enrollment period under the Affordable Care Act (ACA). It will be followed by three other surveys over the course of the next two years that will capture the changing experiences and attitudes of this same group of 2,000 people over time, whether they obtain coverage or remain uninsured. The report analyzes the uninsured…

  • Key Issues in State Implementation of the New and Expanded Home and Community-Based Services Options Available Under the Affordable Care Act

    Issue Brief

    This brief summarizes the key issues identified and discussed by participants in Kaiser Family Foundation’s Commission on Medicaid and the Uninsured's July 16, 2013 roundtable meeting on state adoption of the new and expanded Affordable Care Act home and community-based services (HCBS) options. While states have made overall progress in rebalancing their long-term care systems in favor of community-based care, state adoption of ACA HCBS options has been relatively slow to date, despite the growing…

  • How Buying Insurance Will Change Under Obamacare

    Perspective

    When the Affordable Care Act’s (ACA) health insurance marketplaces (also known as “exchanges”) go online this October, millions of people are expected to apply for private insurance coverage. Nobody expects the launch will be perfect, with no hitches and problems.  The law not only replaces a fragmented and confusing assortment of plan options in today’s individual insurance market, but it also integrates tax credits to help people pay their premiums, which requires an entirely new…

  • Getting into Gear for 2014: An Early Look at Branding and Marketing of New Health Insurance Marketplaces

    Issue Brief

    Based on a review of publicly available materials as of September 2013, this brief provides an examination of the Marketplace branding strategies, websites, and marketing materials, providing insight into how consumers will be introduced to the Marketplaces and some of the key messages and approaches the Marketplaces will utilize to encourage individuals to enroll. As of September 2013, states and the federal government are on the eve of their October 1st launch of open enrollment…