Affordable Care Act

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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  • Webinar: The ACA and What It Means for Black Americans

    Event Date:
    Event

    Now that the Affordable Care Act's major provisions to expand health insurance coverage are in effect, time is ticking for consumers to sign up for a health insurance plan through the Federal or State Health Insurance Marketplaces.  Monday, March 31, is the last day to sign up for coverage through the Marketplaces. While there is no deadline for eligible people to enroll in Medicaid, many consumers are still confused or uninformed about their coverage options…

  • The Affordable Care Act in California: Briefing and Panel Discussion

    Event Date:
    Event

    In the first of many events to highlight Affordable Care Act (ACA) implementation in the states and on the front lines across the country, the Kaiser Family Foundation partnered with the Blue Shield of California Foundation to examine ACA implementation in California (CA) at a Washington, D.C., briefing and panel discussion on February 19, 2014. State and county officials, experts and advocates discussed the latest developments and lessons learned about the ACA implementation in California, a…

  • The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities

    Issue Brief

    Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.

  • How Will the Uninsured Fare Under the Affordable Care Act?

    Fact Sheet

    This report explains how the ACA expands coverage nationally, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people are eligible for Medicaid or financial assistance in the Marketplace. For states…

  • Measuring Changes in Insurance Coverage Under the Affordable Care Act

    Issue Brief

    This data note discusses the details and timing of some of the private and federal surveys that will be used to look at how coverage has changed due to the Affordable Care Act. Different surveys offer different information and insight into coverage under the ACA, and we discuss the contributions and challenges in each type of effort.

  • Enrollment Surge Did Not Change Public’s Views on the Affordable Care Act

    News Release

    Most Common Reason for Remaining Uninsured is Not Being Able to Find an Affordable Plan; Just 7 Percent Would Rather Pay a Fine than Pay for Coverage As the Supreme Court Considers Challenge, a Majority Supports the Law's Requirements for Contraceptive Coverage, Including for Employers with Religious Objections Despite the news that 8 million people have signed up for health insurance through the ACA’s new marketplace, the April Kaiser Health Tracking Poll finds no change…

  • Visualizing Health Policy: Public Opinion At The End of the First Open Enrollment Period

    Other Post

    This Visualizing Health Policy infographic takes a look at public opinion of the Affordable Care Act at the end of the first enrollment period, including the persistent deep partisan divisions, the sources of people’s impressions, and the favorable views towards many of the ACA’s least well-known provisions. Further, more people want Congress to improve the ACA than to repeal it. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical…