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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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  • 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…

  • National Survey Finds 10.6 Million People Helped By Navigators and Assisters During the Affordable Care Act’s First Open Enrollment Period

    News Release

    An estimated 10.6 million people nationally received personal help from navigators and assisters during the Affordable Care Act's first open enrollment period, finds a new Kaiser Family Foundation survey of navigators and assister programs nationally. The survey estimates that the 4,400 assister programs operating nationally had an estimated 28,000 full-time staff and volunteers, suggesting each assister would have helped more than 370 people on average during the six-month open enrollment period that ran from October…

  • What’s Trending in Health Care? Conservative Ideas

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    Event Date:
    Event

    On Monday, July 28, the Kaiser Family Foundation held an interactive web briefing to examine the experiences and lessons of four states -- Colorado, Connecticut, Kentucky, and Washington -- that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA.  The briefing drew upon a new issue brief released today by the Foundation’s Kaiser Commission on Medicaid and the Uninsured (KCMU), What Worked and…

  • What’s Trending in Health Care? Conservative Ideas

    News Release

    What’s Trending in Health Care? Conservative Ideas In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system. All previous columns by Drew Altman are available online.

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    News Release

    On Monday, July 28 from 1 p.m. to 2:00 p.m. EDT, the Kaiser Family Foundation will hold an interactive web briefing to examine the experiences and lessons of four states - Colorado, Connecticut, Kentucky, and Washington - that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA. The briefing will draw upon a new issue brief released today by the Foundation’s Kaiser Commission…

  • The Politics of Obamacare: How the Affordable Care Act is Playing in the Midterm Elections

    Event Date:
    Event

    In 2010, many political analysts and journalists cited the debate over, and enactment of, the Affordable Care Act (often called "Obamacare") as one factor that helped spark the conservative Tea Party movement and the Republican takeover of the House in that year's Midterm Elections. Four years later, the law's major coverage provisions have taken effect, resulting in new health coverage for millions of Americans, but public opinion on the law remains deeply divided along partisan…

  • 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.