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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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  • The Twin Goals of Health Insurance

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, examines a study finding Massachusetts' health reform saved lives in the context of health insurance's twin goal: better access to improve health and economic security.

  • Women and Health Care in the Early Years of the ACA: Key Findings from the 2013 Kaiser Women’s Health Survey

    Report

    This report addresses a wide range of topics that are at the heart of women’s health care, as well as changes that women may experience as a result of the Affordable Care Act (ACA). The findings in the report, based off a nationally representative survey conducted by the Kaiser Family Foundation, highlight differences in health care for uninsured, low-income, and minority women. Other focus areas include: coverage, access, and affordability; connections to health providers; access…

  • The Next Big Health-Care Issue

    From Drew Altman

    Drew Altman, in The Wall Street Journal‘s Think Tank, writes that the next big concern for the Affordable Care Act (ACA) will be how much premiums increase in exchanges for 2015. He discusses the factors to focus on to put this issue in perspective when states report premium increases.

  • New Survey Documents Women’s Health Care, Coverage and Early Experiences with the Affordable Care Act

    News Release

    A comprehensive survey released today by the Kaiser Family Foundation provides a snapshot of women and their health coverage and care during a time of transition as important Affordable Care Act insurance market changes began to take root.   These include many changes that affect women including a prohibition on using gender in setting premiums, as well as broadening access to a more comprehensive range of preventive services benefits without cost sharing. The Kaiser Women’s Health…

  • Uncompensated Care for the Uninsured in 2013: A Detailed Examination

    Report

    This report provides estimates of spending for uncompensated care, in 2013, just before implementation of health reform’s major coverage provisions. The report estimates the amount of uncompensated care provided, analyzes the site of care for uncompensated services, and details sources of funding for uncompensated care. These estimates provide an important baseline against which to measure major changes that are occurring under the ACA.

  • Avoiding the Wrong Lessons From the VA and HealthCare.gov Problems

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on May 27, 2014. Problems with the launch of HealthCare.gov and with veterans hospitals allegedly concealing long waits for care feed a narrative that government doesn’t work. But many government programs, including Medicare and Social Security, work well. And there are as many examples of corporate bungling–GM and its ignition switches, BP in the Gulf–as there are of government bungling. One impulse when government fails is to…

  • Kaiser Health Tracking Poll: May 2014

    Feature

    More than four years after the Affordable Care Act's enactment and more than a month after the close of open enrollment, six in 10 Americans say the health reform law has not had an impact on them or their families, Kaiser’s May Tracking Poll finds. Among those who say it has, Republicans are much more likely to say their families have been hurt by the law than helped, while Democrats are more likely to say…

  • Health Policy News Index, May 2014: ACA Enrollment Top Health Policy Story

    Kaiser Health Policy News Index: May 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. This month’s Index finds that news about the Affordable Care Act (ACA) enrollment numbers was followed by more than half the public, ranking behind two non-health news stories (the kidnapping of Nigerian schoolgirls and the ongoing conflict between…