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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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  • Coordinating Coverage and Care in Medicaid and Health Insurance Exchanges

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured convened a roundtable discussion on August 31, 2010 with a group of national and state experts to discuss key issues related to coordinating coverage and care in Medicaid and the new Health Insurance Exchanges under health reform. The Patient Protection and Affordable Care Act requires states to create a coordinated, simple and technologically-supported process through which individuals may obtain Medicaid, Children’s Health Insurance Program and subsidized Exchange…

  • Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System

    Event Date:
    Event

    This report highlights the severe challenges cancer patient may face in paying for life-saving care even when they have private health insurance. Jointly authored by the Kaiser Family Foundation and the American Cancer Society, the report profiles 20 patients and illustrates the potential difficulties people diagnosed with cancer or other serious illnesses have in maintaining affordable health insurance and paying for their health care. The patients in the report and accompanying video were selected to…

  • The Public and the Health Care Delivery System

    Poll Finding

    This survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlights the public’s attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans’ experiences with issues more typically discussed by health policy experts – including electronic medical records, coordination of care and comparative effectiveness – all of which have become serious components of reform plans and some of which have…

  • Health Care Reform Newsmaker Series: Sen. Max Baucus

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    Event

    This May 21, 2009 webcast features Senate Finance Committee Chairman Max Baucus (D-MT) at a Health Care Reform Newsmaker media briefing sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only sessions, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session. Transcript (.pdf) Video

  • Medicaid Managed Long-Term Services and Supports: Are More Caution and Oversight Needed?

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    Event

    The Alliance for Health Reform and AARP sponsor an August 3rd briefing to discuss who is being served by Medicaid managed care, how enrollment is determined, and whether sufficient oversight of the programs exist. Speakers will explore such questions as: Does Medicaid managed care cover a full range of long-term services and supports, including home- and community-based services? Is Medicaid managed care as a strategy part of state plans for 2014, and the challenges and…

  • KFF June Tracking Poll Finds Health Care in the November 2010 Mix

    Perspective

    The start of summer finds Americans remain divided on the health reform law, but favorable views of the new law increased seven percentage points over the past month to 48 percent, compared to 41 percent who have “generally unfavorable” views and 10 percent who have yet to make up their minds, according to the Kaiser Family Foundation’s newly released June Health Tracking Poll. With four months remaining until the midterm congressional elections, an early look…

  • New Tracking Poll Finds Americans Remain Divided Over Health Law

    Perspective

    With the November midterm elections just weeks away, Americans remain chronically divided over the Patient Protection and Affordable Care Act, but most say that their feelings – pro and con -- about the health reform law are not a dominant factor in how they will vote for Congress or whether they will go to the polls, according to the new Kaiser Health Tracking Poll. Views on health reform tightened up in October, with 42 percent…

  • Health Insurance Coverage for Older Adults: Implications of a Medicare Buy-In

    Issue Brief

    As the Senate debates comprehensive health reform legislation, the idea of a Medicare buy-in option for uninsured adults aged 55-64 has re-emerged as a potential component of a reform plan. This Kaiser Family Foundation policy brief provides an updated profile of the more than 4 million uninsured people between ages 55 and 64 and examines historical proposals to allow uninsured older adults to purchase Medicare coverage. It also examines barriers to securing affordable coverage in…

  • Getting Connected: Can the ACA Improve Access to Health Care in Rural Communities?

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    Event

    Residents of rural communities face unique health care challenges, including fewer health care providers, higher rates of chronic disease, and lower adoption rates of health information technology. This October 13 briefing, cosponsored by the Alliance for Health Reform and the United Health Foundation, looked at the many provisions in the Patient Protection and Affordable Care Act (ACA) that speak to the needs of rural communities, with a focus on boosting the health care workforce and…

  • Accountable Care Organizations: A New Paradigm for Health Care Delivery?

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    Event

    The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the arrangements are burdensome and too hard to achieve. This briefing addresses questions raised by the law and the subsequent regulation implementing ACOs, including: How will…