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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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  • July Kaiser Health Tracking Poll: Public Still Divided on ACA, Few Believe the Law Will Improve Consumer Protections

    Perspective

    Overall public opinion on the health reform law remains unchanged this month, with 42 percent of Americans holding a favorable view and 43 percent an unfavorable view. Even though previous Health Tracking polls have consistently shown that consumer protections were one of the least controversial and most widely supported provisions of the health reform law, the July poll finds that just one in five Americans think the law will lead to improvements in consumer protections…

  • What is a Mini-Med Plan?

    Perspective

    One of the early insurance market changes in the Affordable Care Act (ACA) phases out caps that some insurance plans impose on the annual dollar amount of benefits they will cover. Plans issued or renewed after September 23, 2010 cannot have annual limits of less than $750,000, and the threshold goes up to $1.25 million in 2011. Annual dollar limits of any kind are prohibited starting in 2014. The federal government has issued waivers from…

  • Kaiser Polling Data Note Finds Regional Differences in Views of Health Reform Law

    Perspective

    Based on the November Kaiser Health Tracking Poll, the latest KFF data note examines regional differences in Americans’ views of the new health reform law. Although many states in the American South and West stand to be disproportionately eligible for federal funds under the new law, the analysis finds that opinions of the law play out quite differently in these regions. Those living in the Western and Northeastern United States are more likely to view…

  • Kaiser December Tracking Poll: Public Remains Divided on Health Reform Law; Significant Number of People Struggle Financially

    Perspective

    As 2010 draws to a close, the latest tracking poll from the Kaiser Family Foundation shows the public still divided in their views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent have a generally unfavorable view of it. As the weak economy continues, the survey finds that a significant number of…

  • Overall Public Support for the Health Reform Law Is Steady from June

    Perspective

    The July Kaiser Health Tracking Poll indicates overall public support for the health reform law is steady from June, while unfavorable views of the law have trended downward somewhat. Half the public (50%) now expresses a favorable view of the law, while 35 percent say they have an unfavorable opinion (down from 41% in June). Seniors’ views of the new law remain more negative than those of their younger counterparts; they tilt towards unfavorable views,…

  • May Kaiser Health Tracking Poll: Four in Ten Say Children and Young Adults Will Be Better Off

    Perspective

    While supporters and opponents of the Affordable Care Act wait for the Supreme Court to announce their decision, support for the law dipped slightly in May, with unfavorable views now outnumbering favorable ones (44 percent versus 37 percent).  As in previous months, the public remains divided on whether the law will leave the country better off (34 percent) or worse off (35 percent). When it comes to their own families, a plurality (37 percent) doesn’t…

  • Public Opinion on Gender Rating

    Perspective

    With the Republican presidential primaries wrapping up, a barrage of new television commercials, radio ads, and fundraising emails has marked the start of the general election campaign. The Affordable Care Act (ACA) continues to be a mainstay election topic for candidates from both major parties. While Republicans focus on advocating repeal of the 2010 health care law, President Barack Obama and the Democratic Party have concentrated on the benefits of the law. And one lesser…

  • Private Insurance Benefits and Cost-Sharing Under the ACA

    Perspective

    The Department of Health and Human Services (HHS) recently released guidance on the two key components that determine the level of protection that private insurance plans will provide to consumers under health reform. The first involves the services that insurance plans must cover, and the second involves how much patients must pay out-of-pocket for those services. The Affordable Care Act (ACA) establishes new rules for what insurers must provide for both components starting in 2014.…

  • Betting on Private Insurers

    Perspective

    Just-released estimates of national health spending in 2010 by the Centers for Medicare and Medicaid Services (CMS) show that 45% of our health care spending is financed by the federal and state governments, primarily through the Medicare and Medicaid programs. This share has grown temporarily in recent years because of the economic downturn, as private insurance has declined and Medicaid has grown. It has also increased due to our demographic destiny: the growing cohort of baby…

  • Medicaid and Its Role in State/Federal Budgets and Health Reform: A Fact Sheet

    Fact Sheet

    This fact sheet highlights key issues about Medicaid, including the structure, financing and purpose of the program, its role for low-income beneficiaries, its share of the federal budget and state budgets and the significant implications of the coverage expansion under the Affordable Care Act. Fact Sheet (.pdf) Related chartpack: Medicaid and Its Role in State/Federal Budgets and Health Reform