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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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  • Visualizing Health Policy: The Public’s Health Care Agenda for 2013

    Other Post

    This month’s Visualizing Health Policy infographic looks at the US public’s priorities for health care in 2013, including actions by state governments, Medicaid expansion, Medicare spending, and spending for specific types of public health activities. See the full-size infographic at The Journal of the American Medical Association The original public opinion poll is available here. View the related Slideshow Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association…

  • Navigator and In-Person Assistance Programs: A Snapshot of State Programs

    Issue Brief

    With the open enrollment period for health insurance exchanges less than six months away, consumers are already asking questions about their new health care options under the Affordable Care Act (ACA). Even in the age of digital information, hands-on consumer assistance could play a key role in helping people understand their insurance choices come 2014 — a recent Kaiser Family Foundation poll showed that two thirds of the uninsured and a majority of Americans overall…

  • Consumer Assistance in Health Reform

    Issue Brief

    With the open enrollment period for health insurance exchanges less than six months away, consumers are already asking questions about their new health care options under the Affordable Care Act (ACA). Even in the age of digital information, hands-on consumer assistance could play a key role in helping people understand their insurance choices come 2014 — a recent Kaiser Family Foundation poll showed that two thirds of the uninsured and a majority of Americans overall…

  • A Profile of Health Insurance Exchange Enrollees

    Report

    The Patient Protection and Affordable Care Act calls for the creation of Health Insurance Exchanges in all states by January 1, 2014. The exchanges are a critical element of the health reform law, aimed at helping individuals and families shop for and purchase health insurance on their own with additional assistance for lower-income individuals and families. The Congressional Budget Office has estimated that approximately 24 million people will purchase coverage through the state health exchanges…

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • How Will Consumers Navigate New Health Care Options? Briefing and Panel Discussion

    Event Date:
    Event

    With the open enrollment period for health insurance exchanges less than six months away, consumers are already asking questions about their new health care options under the Affordable Care Act (ACA). Even in the age of digital information, hands-on consumer assistance could play a key role in helping people understand their insurance choices come 2014 — a recent Kaiser Family Foundation poll showed that two thirds of the uninsured and a majority of Americans overall…

  • Health Coverage by Race and Ethnicity: The Potential Impact of the Affordable Care Act

    Issue Brief

    Executive Summary One of the key goals of the Affordable Care Act (ACA) is to reduce the number of uninsured through a Medicaid expansion and the creation of health insurance exchange marketplaces with advance premium tax credits to help moderate-income individuals pay for this coverage. Given that people of color are at disproportionate risk of being uninsured and having low incomes, the ACA coverage expansions could particularly benefit communities of color and advance efforts to…

  • California’s Uninsured on the Eve of ACA Open Enrollment

    Report

    This report presents the findings of a baseline survey of California’s uninsured adult population just before the start of the first open enrollment period under the Affordable Care Act (ACA). It will be followed by three other surveys over the course of the next two years that will capture the changing experiences and attitudes of this same group of 2,000 people over time, whether they obtain coverage or remain uninsured. The report analyzes the uninsured…

  • Kaiser Health Tracking Poll: September 2013

    Feature

    September 2013 Kaiser Health Tracking Poll gauges public opinion on the ACA days before open enrollment for Obamacare health insurance marketplaces begins.

  • Obamacare and You

    Fact Sheet

    Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people. Click on the links below to learn more: If You Are Uninsured  Haga clic para leer en español  If You Are Low-Income and May Qualify for Medicaid  Haga clic para leer en español If You Have a Pre-Existing Condition Haga clic para leer en español If You Buy Coverage in the Individual Market…