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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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  • The Potential Side Effects of Halbig

    Perspective

    The Halbig case, if it prevails, would have far-reaching side effects on the Affordable Care Act’s employer mandate and the functioning of the individual insurance market.

  • The Ohio Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and health care delivery in Ohio under the Affordable Care Act (ACA).

  • A Closer Look at the Courts’ Impact on Health Policy

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman maps what the combined impact of the Supreme Court decision on the Affordable Care Act’s Medicaid expansion and a plaintiff’s win in Halbig would look like and discusses the impact of court decisions on health policy.

  • One Year into Duals Demo Enrollment: Early Expectations Meet Reality

    Perspective

    One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

  • Health Care Access and Coverage for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community in the United States: Opportunities and Challenges in a New Era

    Perspective

    This Policy Insight looks at the challenges and questions surrounding recent policy changes that are expected to increase health insurance coverage and access to care for lesbian, gay, bisexual and transgender (LGBT) individuals and their families, including the impact of the Affordable Care Act (ACA) and the Supreme Court's DOMA decision.

  • Wisconsin’s BadgerCare Program and the ACA

    Fact Sheet

    This fact sheet provides an overview of changes to BadgerCare, Wisconsin's 1115 waiver demonstration project, and how it relates to the Affordable Care Act's Medicaid expansion.

  • Kaiser Health Tracking Poll: February 2014

    Feature

    The February 2014 Kaiser Health Tracking Poll finds that those who are most likely to be customers in the Affordable Care Act (ACA)’s new insurance exchanges (the uninsured and those who purchase their own coverage) are more likely to prefer less costly plans with narrow provider networks over more expensive plans with broader networks, while the public overall has the opposite preference. Overall opinion of the ACA remains about the same as it has been…

  • All Eyes on the Supreme Court: More than Birth Control at Stake

    Issue Brief

    On March 25th, the Supreme Court will hear two cases brought by for-profit corporations challenging the ACA’s contraceptive coverage rule on religious grounds. These two corporations are Hobby Lobby, a national chain of craft stores owned by a Christian family and Conestoga Wood Specialties, a cabinet manufacturer, owned by a Mennonite family. Beyond the impact on the ACA and contraceptive coverage, the Court’s decision may have implications for religious rights of employers and employees, as…

  • The Utah Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of the population health, health coverage, and health care delivery in Utah in the era of health reform.