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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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  • I lost my job and health benefits. I’d like to continue coverage under my group plan through COBRA but am worried I won’t be able to afford it. Is there any help for me?

    FAQs

    Yes.  The American Rescue Plan provides for new, temporary COBRA premium subsidies for people who lost their jobs or had their hours cut so they no longer qualify for group health benefits.  The law provides for a 100% premium subsidy for COBRA for up to 6 months.  The first subsidy-eligible month is April 2021 and the last subsidy-eligible month is September 2021.  Employers will pay the COBRA premium for subsidy-eligible individuals and be reimbursed by…

  • What happens after the COBRA subsidies end in September?

    FAQs

    You can continue on COBRA unsubsidized until your 18 months of COBRA eligibility ends. In addition, you will have the option to enroll in marketplace coverage when the subsidy ends in September.  Loss of the COBRA subsidy will make you eligible for a special enrollment period (SEP) to sign up for marketplace coverage.  If you make your plan selection before the end of September, new marketplace coverage will take effect on October 1. 

  • I hear there is a special enrollment opportunity for people with very low income. How does that work?

    FAQs

    Starting August 25, 2025, the special enrollment opportunity that allowed individuals with incomes at or below 150% of the federal poverty level to sign up for Marketplace coverage year-round --simply due to their low income --was eliminated. Individuals at this income level might still qualify for special enrollment under other special enrollment events, such as when they lose coverage due to job loss or lose Medicaid coverage.

  • I notice something called “Easy pricing” under the plan name on HealthCare.gov. What does that mean?

    FAQs

    "Easy pricing" refers to a "standardized" plan design on HealthCare.gov that aims to make it simpler to compare plans by applying the same to each category of essential health benefits across all easy pricing plans in the same metal level. For example, all Bronze-level easy pricing plans have the same deductible and copays. By contrast, non-standardized Bronze-level plans might have different deductible and copay amounts. Easy pricing plans are marked with a green circle with…

  • I’m a few years away from turning 65 and becoming eligible for Medicare, and I would like to sign up for a Marketplace plan in the meantime. I am a lawfully-present immigrant, and I hear there&#82...

    FAQs

    In general, lawfully-present immigrants (except for DACA recipients) are eligible to buy a plan on the ACA Marketplace. The new law does not affect eligibility for Marketplace coverage for lawfully-present immigrants. Currently, depending on your income and household size, you may be eligible for premium tax credits to offset the cost of your premiums. However, beginning in 2027, the types of lawfully-present immigrants eligible for tax credits will become much more limited than it is…

  • ¿Qué ingreso cuenta para determinar mi elegibilidad para recibir subsidios?

    FAQs

    La elegibilidad para los créditos fiscales para las primas (subsidios) se basa en su ingreso bruto ajustado modificado o MAGI. Cuando presenta una declaración federal de impuestos, debe informar su ingreso bruto ajustado (que incluye sueldos y salarios, intereses y dividendos, beneficios por desempleo y varias otras fuentes de ingresos). MAGI modifica su ingreso bruto ajustado añadiéndole cualquier beneficio de Seguro Social sujeto a impuestos que reciba, cualquier interés exento de impuestos que gane y…

  • ¿Qué pasa si no actualizo mi aplicación para asistencia financiera?

    FAQs

    Si no actualiza su solicitud, en la mayoría de los casos, el mercado ajustará automáticamente la cantidad de su crédito fiscal para la prima para el próximo año. Si resulta ser menor que la cantidad para la que realmente es elegible, tendrá que pagar más prima cada mes de lo que hubiera tenido que pagar, aunque puede recibir un reembolso por el resto cuando presente su declaración anual de impuestos. Por otro lado, si el…

  • Soy un adulto joven y necesito seguro de salud. ¿Cuáles son mis opciones de cobertura?

    FAQs

    Hay varias opciones que pueden estar disponibles: Si sus ingresos son de $21.597 o menos en 2026 (138% del nivel federal de pobreza para un adulto solo), puede calificar para cobertura de Medicaid. No todos los estados han optado por ampliar la elegibilidad para Medicaid para este nivel de ingresos. Consulte con un navegador u otro asistente usando la herramienta “Buscar Ayuda Local” en su mercado de seguros para obtener más información sobre la elegibilidad…

  • ¿Pueden los inmigrantes obtener ayuda para pagar las primas y/o los costos compartidos para el seguro de salud en los mercados de seguros?

    FAQs

    Usualmente, la mayoría de los inmigrantes legalmente presentes pueden obtener subsidios para ayudar a pagar las primas y los costos compartidos del seguro de salud obtenido en los mercados. Al igual que los ciudadanos, pueden calificar para créditos fiscales para primas que varían en una escala móvil basada en los ingresos. Por lo general, las personas deben tener ingresos por lo menos del 100% del nivel federal de pobreza ($15,650 para un individuo adulto o…