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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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  • National Survey Finds 10.6 Million People Helped By Navigators and Assisters During the Affordable Care Act’s First Open Enrollment Period

    News Release

    An estimated 10.6 million people nationally received personal help from navigators and assisters during the Affordable Care Act's first open enrollment period, finds a new Kaiser Family Foundation survey of navigators and assister programs nationally. The survey estimates that the 4,400 assister programs operating nationally had an estimated 28,000 full-time staff and volunteers, suggesting each assister would have helped more than 370 people on average during the six-month open enrollment period that ran from October…

  • What’s Trending in Health Care? Conservative Ideas

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    Event Date:
    Event

    On Monday, July 28, the Kaiser Family Foundation held an interactive web briefing to examine the experiences and lessons of four states -- Colorado, Connecticut, Kentucky, and Washington -- that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA.  The briefing drew upon a new issue brief released today by the Foundation’s Kaiser Commission on Medicaid and the Uninsured (KCMU), What Worked and…

  • Survey Finds Approximately 3.4 Million Previously Uninsured Adult Californians Obtained Coverage Since Start of the Affordable Care Act’s First Open Enrollment Period

    News Release

    Immigration Status and Fears Pose Challenges to Further Expanding Coverage Among Hispanics Affordability Key Obstacle to Enrollment for Those Who Remain Uninsured MENLO PARK, Calif. -- Nearly six in 10 (58%) previously uninsured Californians report getting health insurance since last summer, finds the second wave of the Kaiser Family Foundation's Longitudinal Panel Survey following the experiences of a randomly selected  panel of uninsured Californians under the Affordable Care Act (ACA). Based on official estimates of…

  • 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.

  • Share of Americans With An Unfavorable View of the Affordable Care Act Rises in July; Majority Continues To Want Congress To Improve, Not Repeal, The Law

    News Release

    A Quarter Incorrectly Believes Newly Insured Under ACA Were Enrolled in a Single Government Plan Majority of the Public Believes the Hobby Lobby Decision Will Trigger New Efforts to Deny Health Coverage On Religious Grounds After remaining steady for several months, the share of Americans expressing an unfavorable view of the Affordable Care Act rose to 53 percent in July, up eight percentage points from June, according to the latest Kaiser Health Tracking Poll. The…

  • The Georgia Health Care Landscape

    Fact Sheet

    The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Georgia and elsewhere across the country. Thousands of Georgians have enrolled in health coverage through the new Health Insurance Marketplace, but Georgia has not implemented the Medicaid expansion, and many low-income adults in the state will likely remain uninsured. This fact sheet provides an overview of the population health, health coverage,…

  • Understanding How States Access the ACA Enhanced Medicaid Match Rates

    Issue Brief

    This brief reviews the rules around the enhanced federal medical assistance percentages (FMAP) provided in the Affordable Care Act (ACA), the process for states to claim the enhanced matching funds and a discussion about what information the new data will provide looking forward.