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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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  • State Marketplace Profiles: Connecticut

    Other Post

    Final update made on September 27, 2013 (no further updates will be made)  Establishing the Marketplace On July 1, 2011, Governor Dan Malloy (D) signed SB921 (Public Act 11-53) into law establishing the Connecticut Health Insurance Exchange.1   Legislation altering the composition of the Exchange Board passed in June 2012.2 3  In December 2012, the Exchange announced that its new name would be “Access Health CT.” Structure: The legislation defines Connecticut’s Health Insurance Exchange as a quasi-governmental organization, specifically "a…

  • State Marketplace Profiles: Idaho

    Other Post

    Final update made on October 3, 2013 (no further updates will be made) Establishing the Marketplace On December 11, 2012, Governor C.L. Otter (R) announced Idaho’s commitment to the establishment of a State-based health insurance Marketplace and on March 28, 2013 signed into law legislation (HB248) creating the Idaho Health Insurance Exchange.1 2  In August 2013, the state announced that the online marketplace would be called Your Health Idaho.3  While the Governor had previously signed an Executive…

  • State Exchange Profiles: Florida

    Other Post

    Final update made on December 14, 2012 (no further updates will be made) Establishing the Exchange In December 2012, Governor Rick Scott (R) announced that Florida would not be pursuing efforts to implement a state-based health insurance exchange.1 Governor Scott has been a vocal opponent of federal health reform and the state has refused multiple funding opportunities available through the Affordable Care Act (ACA).2 Florida was also the lead plaintiff in a lawsuit brought by 26 states…

  • Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010

    Feature

    Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010 Download Source Kaiser Family Foundation analysis of 2010 insurer filings to the National Association of Insurance Commissioners and the California Department of Managed Health Care using the Mark Farrah Associates Health Coverage Portal TM. Market share was calculated as the percent of the state’s individual insurance market enrollment accounted for by each parent company (measured in member months)  

  • Translating The Medicaid Expansion Into Increased Coverage: The Role Of Application Assistance

    Event Date:
    Event

    Under the Affordable Care Act (ACA), beginning in 2014 all states will employ streamlined, technology-driven enrollment systems to help eligible people sign up for insurance affordability programs, including Medicaid, the Children's Health Insurance Program and the new health insurance exchange marketplaces. Even with these streamlined systems in place, application assistance will be important for helping to translate the ACA's Medicaid and other coverage expansions into increased coverage. The Kaiser Family Foundation's Commission on Medicaid and…

  • The Affordable Care Act: Three Years Post-Enactment

    Issue Brief

    On March 23, 2010, the Affordable Care Act (ACA) was signed into law. Although the date for full implementation of most provisions of the law is January 1, 2014, the ACA has already led to progress toward expanded coverage of the uninsured; improved access and better care delivery models; broader access to community-based long-term care; and more integrated care and financing for beneficiaries who are dually eligible for Medicare and Medicaid. The brief provides an…

  • State Marketplace Profiles: Minnesota

    Other Post

    Final update made on November 12, 2013 (no further updates will be made) Establishing the Marketplace On October 31, 2011, Governor Mark Dayton (D) signed Executive Order 11-30 which charged the Minnesota Health Care Reform Task Force with recommending strategies to improve overall health care delivery in Minnesota, including advising and overseeing an Exchange Advisory Task Force.1   Building on the work of the Advisory Task Force, on March 20, 2013, Dayton signed into law legislation…

  • How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options

    Issue Brief

    Under the Affordable Care Act (ACA), states are afforded a number of new and expanded opportunities, including enhanced federal financing, to improve access to and delivery of Medicaid long-term services and supports (LTSS). This policy brief provides an overview of six key Medicaid LTSS options created or enhanced by the 2010 law and state adoption of these options to date. Nearly every state (47 states and DC) has taken steps forward with at least one…