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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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  • Quick Take: Medicaid: 3 Key Issues to Watch in 2013

    Fact Sheet

    2013 will be a historic year for Medicaid with the implementation of major provisions to expand coverage and streamline enrollment in the Affordable Care Act (ACA) less than a year away, a surge in activity around care delivery reforms that seek to improve care and potentially reduce costs, and the unfolding of fiscal developments at the state and federal level. Today, Medicaid provides health and long-term care coverage to more than 60 million low-income children,…

  • Visualizing Health Policy: Premium Changes in the Affordable Care Act’s Insurance Marketplaces 2014-2015

    News Release

    This Visualizing Health Policy infographic illustrates the change in monthly premiums by county, and select cities, from 2014 to 2015 for a 40-year-old person covered by the second-lowest-cost silver “benchmark” plan in the Affordable Care Act’s insurance marketplaces. Premium changes were greatest in Summit County, Colo. (45% decrease) and southeastern Alaska (34% increase), before tax credits. After accounting for tax credits, premiums for a 40-year-old person with an annual income of $30,000 would remain flat in…

  • High Health-Care Prices: More Talk Than Action  

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman explores how price is the major factor that distinguishes the cost of our health care system from those in other developed nations, yet most efforts in the U.S. to address health-care costs don't focus on price much at all. All previous columns by Drew Altman are available online.

  • Harvard and Growth in Health Care Cost Sharing

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explains why recent discussion of Harvard University’s introduction of new health insurance cost sharing measures amounted to “making a mountain out of a mole hill”.

  • Abortion Coverage in Marketplace Plans, 2015

    Issue Brief

    This brief analyzes state policies and insurer coverage decisions affecting the availability of abortion coverage in 2015 insurance plans offered through the Marketplaces. It finds that abortion coverage is unavailable in a total of 31 states, 24 of which have enacted laws that ban or restrict abortion coverage in plans sold through their Marketplaces and 7 of which have no abortion coverage restrictions but also have no Marketplace plans offering it.

  • Kaiser Health Policy News Index: January 2015

    Feature

    The January 2015 Kaiser Health Policy News Index finds fewer than 3 in 10 Americans report paying attention to recent health policy news stories; considerably less than the shares who report following national and international news stories such as tension between the police and the mayor in New York City and the Charlie Hebdo attack in Paris.

  • Majority of Public Says Congress Should Act to Close Gaps if the Supreme Court Bars Financial Help for Purchasing Insurance in States Relying on healthcare.gov; Most in Potentially Affected States Want Their State To Set Up Its Own Marketplace if Needed

    News Release

    Views Mixed on Changes to Definition of Full-Time Work For Employer Mandate, with More Opposed than Supportive, And a Third Saying They Don't Know Enough to Say Public Remains Divided Over Next Steps for the Affordable Care Act, Though Most Expect Major or Minor Changes under GOP Congress this Year Though few Americans are paying attention to the pending Supreme Court case over whether the health care law says that people in all states can…

  • Proposed Medicaid Expansion in Tennessee

    Fact Sheet

    This fact sheet describes Tennessee’s 1115 waiver demonstration project, Insure Tennessee, which expands the State’s Medicaid program under the Affordable Care Act.

  • The Cost of Care with Marketplace Coverage

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2015 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).

  • New Kaiser Survey Finds Eleven Million Newly Insured Adults As of Mid-December, But Nearly Half Who Remained Uninsured One Year After Full Implementation of the Affordable Care Act Were Eligible for Medicaid or Marketplace Tax Credits

    News Release

    Many Of The Remaining Uninsured Say They Didn’t Seek Coverage or Considered It Too Expensive, While Others Were Told (Or Believed) They Were Not Eligible About 11 million adults had become newly insured under the Affordable Care Act by mid-December 2014, according to a new national survey of more than 10,000 adults by the Kaiser Family Foundation.  Nearly half of the approximately 30 million adults who remained uninsured were eligible for assistance under the law,…