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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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  • Nine in Ten Uninsured Unaware that the Affordable Care Act’s Second Open Enrollment Period Starts in November

    News Release

    Most of Those Without Health Coverage Report Knowing Little or Nothing About the Insurance Marketplaces or About the Financial Assistance Available to Low- and Moderate-Income Families Broader Public Opinion on the Law Still Tilts Unfavorably, Though Gap Has Narrowed Since July and Returned to Pre-Rollout Levels With the second annual open enrollment period under the Affordable Care Act set to begin Nov. 15, the latest Kaiser Family Foundation tracking poll finds major gaps in the…

  • Analysis: Opportunities Under the ACA for Addressing Intimate Partner Violence Among Women With HIV

    News Release

    An estimated 36 percent of women in the U.S. report having experienced intimate partner violence (IPV), also called domestic violence, but among HIV positive women 55 percent report such experiences. A new Kaiser Family Foundation analysis looks at opportunities to address IPV in the Affordable Care Act (ACA) that could help women who are HIV positive or at risk for HIV. The analysis, HIV, Intimate Partner Violence and Women: New Opportunities Under the Affordable Care Act, looks…

  • How the Midterms Factor Into Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how Democratic victories in several close gubernatorial races on Tuesday could revive efforts to expand Medicaid.

  • Web Briefing for Journalists: Consumer Issues Ahead of the Affordable Care Act’s Second Open Enrollment Season

    Event Date:
    Event

    The Affordable Care Act's second annual open enrollment period starts Nov. 15 and runs until Feb. 15 -- a three-month window for Americans to shop for and purchase new health coverage, or change their plan through Healthcare.gov or their state-run insurance marketplace.  This year's open enrollment season poses both new and recurring challenges for consumers:  How are premiums for marketplace plans changing, and what do the changes mean for consumers?  Why might current marketplace customers…

  • Quality of Care in Community Health Centers and Factors Associated with Performance

    Issue Brief

    This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.

  • La reforma del cuidado de salud llega al público

    Video

    ¿Esta confundido acerca de cómo la nueva ley de reforma de salud realmente funciona? Este video explica los problemas relacionados con el sistema de salud actual, los cambios que están sucediendo ahora, y los cambios importantes que se anticipan para el 2014.

  • Obamacare y Usted: Si tiene bajos ingresos y puede calificar para Medicaid

    Fact Sheet

    Obamacare crea muchas formas de obtener cobertura de salud. Usted puede aprender sobre sus opciones llenando una única aplicación. Así, se le dirá si califica para cobertura gratis o a bajo costo a través del programa Medicaid, o a través de los nuevos Mercados de Seguros Médicos que han sido establecidos en cada estado. Usted debería aplicar para cobertura aunque en el pasado no haya tenido la capacidad de tenerla a través del Medicaid o…

  • Obamacare y Usted: Si tiene seguro médico a través de un empleador

    Fact Sheet

    Si usted tiene cobertura de beneficios de salud a través de su empleador o del empleador de un miembro de su familia, usted probablemente pueda mantener esa cobertura y no tener que hacer ningún cambio. En la mayoría de los casos, la cobertura de su empleador satisface los requerimientos de la ley sobre la obtención de seguro. Cambios en la cobertura del empleador Algunas características de la cobertura de su empleador pueden ya haber cambiado…