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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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  • A Perilous Gap in Health Insurance Literacy

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how progress in expanding coverage requires greater attention to the problem of health insurance literacy.

  • Premiums Set to Decline Slightly for Benchmark ACA Marketplace Insurance Plans in 2015

    News Release

    Analysis of 15 States and D.C. Also Finds Changes Vary Across States and Insurers Results Suggest Consumers Should Shop Carefully When Open Enrollment Begins November 15 MENLO PARK, Calif. -- An early look at the cost of health insurance in 16 major cities finds that average premiums for the benchmark silver plan – the one upon which federal financial help under the Affordable Care Act to consumers is based – will decrease slightly in 2015. …

  • Kaiser Health Tracking Poll: August-September 2014

    Feature

    The latest Kaiser Health Tracking Poll includes a special look at registered voters’ views and what role, if any, the the Affordable Care Act might be playing in the upcoming midterm election. Partisan divisions on the law are as deep as ever, not only when it comes to overall opinion but also in the public’s perception of how the law has impacted their own families and the next steps they want Congress to take.

  • Health Coverage for the Black Population Today and Under the Affordable Care Act

    Fact Sheet

    The Affordable Care Act (ACA) could help many uninsured Blacks through the law’s expansion of Medicaid and the creation of new health insurance exchange marketplaces with tax credits to help moderate-income people purchase coverage. This brief provides an overview of the Black population in the U.S., their health coverage today and the potential impact of the ACA coverage expansions.

  • What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence

    Issue Brief

    Medicaid now covers more than 1 in every 5 Americans, and millions of uninsured individuals will become newly eligible for Medicaid under the ACA. Considering Medicaid’s large and growing coverage role, an evidence-based assessment of the program’s impact on access to care, health outcomes, and quality of care is of major interest. This brief takes a look at what the research literature shows regarding the difference Medicaid makes.

  • Employer-Sponsored Family Health Premiums Rise a Modest 4 Percent in 2013, National Benchmark Employer Survey Finds

    News Release

    Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2013 Employer Health Benefits Survey. This year's rise in premiums remains moderate by historical standards. The 15th annual Kaiser/HRET survey of more than 2,000 small and large employers provides a detailed picture of the status…

  • Why Premiums Will Change for People Who Now Have Nongroup Insurance

    Perspective

    The federal government recently released draft regulations that address the benefits, market rules, and rating practices for nongroup coverage. Before reform, the nongroup market was widely acknowledged to be broken, with restricted access, limited benefits, high administrative costs, and frequent and large premium increases subject to inadequate oversight. Recent requests for large premium hikes for nongroup coverage in some states, at a time when the group market is experiencing very low increases, have revived concerns about current pricing…