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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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  • Kaiser Health Policy News Index: June 2014

    Feature

    This month's Health Policy News Index finds more than six in 10 say they followed news about long waiting lists for those seeking care at Veterans Affairs (VA) medical facilities closely. That makes the VA story the most closely followed health story in the first half of 2014, with slightly more people following it than followed several ACA enrollment stories earlier this year.

  • What Women Think of the Core Issue in the Hobby Lobby Case

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case. Overall, by a margin of…

  • New Analysis Finds Out-of-Pocket Prescription Drug Spending Decreasing on Average, But More People Spending in Excess of $1,000 a Year

    News Release

    A new Kaiser Family Foundation analysis finds that average annual out-of-pocket prescription drug spending for workers and family members decreased from a recent high of $167 in 2009 to $144 in 2014. Most of the decline in out-of-pocket spending occurred between 2009 and 2012 and is likely due to generic substitution for popular drugs that lost patent protection. The decline in out-of-pocket-spending continued from 2012 to 2014 with nearly two-thirds of the decline during this…

  • Where President-elect Donald Trump Stands on Six Health Care Issues

    Issue Brief

    Where does President-elect Donald Trump stand on key health care issues? This snapshot outlines his positions and policy statements during the campaign on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, and women's reproductive health.

  • The Bigger Story, and Agenda, Behind GOP Changes to Obamacare, Medicare and Medicaid

    From Drew Altman

    This column was published as a Wall Street Journal Think Tank column on November 21, 2016. Early media coverage of the Republican health-care agenda has concentrated on plans to repeal and then replace the Affordable Care Act. The larger story is GOP preparations for a health policy trifecta: to fundamentally change the ACA, Medicaid and Medicare–all three of health care’s major programs–and in the process, fundamentally alter the direction of the federal role in health and core elements…

  • How the Republican Health Agenda Could Play Out

    From Drew Altman

    In this Wall Street Journal Think Tank column Drew Altman discusses how Republicans will assume ownership of health care’s policy and political problems as they assume control, and how that may affect their plans for the Affordable Care Act, Medicaid and Medicare.

  • What’s at Stake in a Potential Repeal of the ACA Medicaid Expansion?

    News Release

    President-elect Trump and Republican leaders in Congress have vowed to repeal the Affordable Care Act (ACA) and replace it with an alternative plan. There are now 32 states (including DC) that have adopted the ACA’s Medicaid expansion. While the details of a repeal-and-replace plan are not yet available to assess its impact, a new brief reveals what’s potentially at stake for Medicaid in the debate by examining the changes in health coverage and financing that…