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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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  • Patient Cost-Sharing in Marketplace Plans, 2016

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

  • Potential Savings from Actively Shopping for Marketplace Coverage in 2016

    Issue Brief

    This analysis looks at how the premiums for the lowest-cost silver plans in Affordable Care Act (ACA) Marketplaces changed between 2015 and 2016. The analysis examines premiums of the 2015 lowest-cost silver plans (in states that used Healthcare.gov in both 2015 and 2016) for a single 40 year-old adult to see how much these premiums increase in 2016 and whether enrollees could obtain lower premiums by switching plans.

  • Most Americans Report a Personal Connection to Those Who Have Abused Prescription Painkillers; Whites More Likely To Be Affected Than Blacks or Hispanics

    News Release

    Poll Finds 9% Say a Family Member or Close Friend Died of an Overdose; 27% Say Either They or Someone Close to Them Has Been Addicted On the ACA This Month, 45 Percent View the Law Unfavorably and 38 Percent View It Favorably With prescription painkiller abuse garnering more attention from the media and policymakers, the latest Kaiser Family Foundation Health Tracking Poll finds most Americans have a personal connection to the issue. In total,…

  • Data Note: Are Nonprofits Requesting an Accommodation for Contraceptive Coverage?

    Issue Brief

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services, including most contraceptives for women. This policy was at the center of a Supreme Court case brought forward by for-profit corporations (Hobby Lobby and Conestoga) that successfully claimed that the contraceptive coverage requirement violated their religious rights. Last month, the Supreme Court agreed to hear yet another challenge (Zubik v Burwell) to the contraceptive…

  • The Impact of the Children’s Health Insurance Program (CHIP): What Does the Research Tell Us?

    Issue Brief

    The Children’s Health Insurance Program (CHIP) was established in 1997 to provide coverage for uninsured children who are low-income but above the threshold for Medicaid eligibility. In 2009, and again in the Affordable Care Act (ACA), Congress extended federal funding for CHIP, but funding will expire a little over a year from now. Decisions about CHIP’s future funding will be consequential as more than 8 million low-income children were covered by CHIP at some point…

  • How Obamacare’s Progress Makes Expanding Coverage Harder

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on July 21, 2014. The Affordable Care Act’s success meeting its initial enrollment goals and the repair of HealthCare.gov seem to have calmed the political waters for Obamacare. But the job of enrolling the uninsured gets harder, not easier, because the remaining uninsured will generally be tougher to reach. Recent surveys show, roughly in line with expectations, that 8 million to 9.5 million fewer adults are uninsured compared with last year before…

  • The Stakes Beyond the Halbig Lawsuit

    From Drew Altman

    In a column for The Wall Street Journal’s Think Tank, Drew Altman discusses if the legal court cases about whether the government can provide tax credits to people in the Affordable Care Act’s federal health exchanges will be perceived by the American people as a legitimate legal question or as more inside-Washington politics.