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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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  • Avoiding the Wrong Lessons From the VA and HealthCare.gov Problems

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on May 27, 2014. Problems with the launch of HealthCare.gov and with veterans hospitals allegedly concealing long waits for care feed a narrative that government doesn’t work. But many government programs, including Medicare and Social Security, work well. And there are as many examples of corporate bungling–GM and its ignition switches, BP in the Gulf–as there are of government bungling. One impulse when government fails is to…

  • The Affordable Care Act and Insurance Coverage in Rural Areas

    Issue Brief

    Rural populations face disparities compared to metropolitan populations in health care. While rural individuals were not more likely to be uninsured than metropolitan counterparts pre-Affordable Care Act, they were poorer and less likely to have private insurance. With coverage changes in the ACA involving an expansion of Medicaid for poor and near-poor populations, decisions by states with large rural populations may cause rural residents to have disparate access to coverage, which may exacerbate cost and…

  • Individual Market Enrollment Ticks Up in Early 2014

    Issue Brief

    This early look at the growth in the individual or nongroup market during the first three months of 2014 uses first quarter enrollment data submitted by insurance companies to state regulators to estimate the size of the market at the end of March. It includes both on and off exchange enrollment and is net of any people leaving the market (whether through plan cancellations or general churn in the market). It does not include the…

  • The Washington State Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and health care delivery in Washington under the Affordable Care Act (ACA).

  • Medicaid Enrollment Snapshot: December 2013

    Issue Brief

    This report focuses on changes in monthly Medicaid enrollment between December 2012 and December 2013. This is a long standing report series that collects monthly Medicaid enrollment data for December (and June, not reported here) going back to 2000. While the most recent data included in this report predate preliminary data released by CMS that show the early effects of full implementation of the ACA, this report series is an important source of historical trend…

  • Medicaid Enrollment: An Overview of the CMS April 2014 Update

    Fact Sheet

    CMS recently released its latest update on Medicaid and CHIP enrollment data, covering the period through April 2014. This fact sheet provides a brief overview of the latest data and what it suggests about the impact of the ACA on Medicaid and CHIP enrollment, providing historical trends for context

  • Webinar for Journalists: Results from Survey of People Who Bought Their Own Health Insurance Under the ACA

    Event Date:
    Event

    The Kaiser Family Foundation held a reporters-only webinar at 11 a.m. ET on Thursday, June 19 to release its new Survey of Non-Group Health Insurance Enrollees, providing a first look at people buying their own health insurance following the implementation of the Affordable Care Act. The first in a series, the new survey captures the previous insurance status of marketplace enrollees and the self-reported health status of enrollees in ACA-compliant coverage purchased on or off…

  • Potential Supreme Court Decision: Who Will Bear the Coverage “Burdens?”

    Issue Brief

    The Supreme Court is expected to reach a decision by the end of June, 2014 on the cases brought forth by Hobby Lobby and Conestoga Wood Specialties, two for profit corporations challenging the ACA’s contraceptive coverage requirement. The plaintiffs contend that the requirement that they include coverage for certain contraceptive services (emergency contraceptive pills and intrauterine devices) in the insurance plans “substantially burdens” both the corporation’s and the owners’ religious rights. During the arguments, several…

  • Advancing Opportunities, Assessing Challenges: Key Themes from a Roundtable Discussion of Health Care and Health Equity in the South

    Issue Brief

    This brief summarizes the primary themes expressed by participants of a roundtable discussion of current and future opportunities and challenges for advancing health care and health equity in the South organized by Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Georgia.