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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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  • Sen. Mark Pryor Spotlights the Health Law’s Rx for Pre-Existing Illnesses

    From Drew Altman

    In a column for The Wall Street Journal’s Think Tank, Drew Altman explains why Senator Mark Pryor’s new campaign ad features the Affordable Care Act’s protections for people with pre-existing medical conditions, the somewhat forgotten “mega provision” of the law.

  • 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.

  • A Perilous Gap In Health Insurance Literacy

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, A Perilous Gap In Health Insurance Literacy, Drew Altman discusses how progress in expanding coverage requires greater attention to the problem of health insurance literacy. All previous columns by Drew Altman are available online.

  • Republicans Have an Edge in Voter Enthusiasm Heading Into Fall, But Few Cite ACA as Motivating Factor

    News Release

    Anti-Obamacare Ads Reaching Most Voters in Competitive Senate Races Health Care Ranks Among Several Second-Tier Issues for Voters in Midterm Elections Behind the Economy The latest Kaiser Family Foundation Health Tracking Poll finds Republicans with a modest edge in terms of voter enthusiasm, but the Affordable Care Act, also called Obamacare, is not the main motivator. The poll finds that 27 percent of Republicans say they are “more enthusiastic” about voting this year than in…

  • In Employer Health Insurance Costs, Stability Is the New Normal

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman looks at the sharply slower growth in premiums for employer health benefits and what it might mean for the future of employer-sponsored coverage.

  •  In Employer Health Insurance Costs, Stability Is The New Normal

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman looks at the sharply slower growth in premiums for employer health benefits and what it might mean for the future of employer-sponsored coverage. All previous columns by Drew Altman are available online.

  • 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.