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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • He observado que se están vendiendo planes de corto plazo por fuera del mercado y que son más económicos. ¿Qué es un plan de corto plazo?

    FAQs

    Los planes de salud de "duración limitada” están diseñados para cubrir una interrupción temporal en la cobertura médica, como cuando una persona se encuentra entre dos empleos. La duración máxima de los planes de corto plazo varía según el estado. Los planes de corto plazo deben informar a los consumidores que estos planes “NO son una cobertura médica integral”: a menudo no cuentan con las protecciones para el consumidor que se encuentran en los planes…

  • ¿Debería reclamar el subsidio por adelantado, al final de año, o ambos?

    FAQs

    Eso depende de usted. Puede hacer que su crédito fiscal anual para las primas se pague directamente a su plan de salud cada mes para reducir su prima mensual de inmediato. O, si puede pagarlo, puede pagar la prima completa del plan de salud usted mismo por adelantado y cobrar el subsidio en una suma global el próximo año cuando presente su declaración de impuestos. O bien, puede hacer que parte del crédito fiscal se…

  • ¿Cuánto puedo ganar y calificar para subsidios para las primas en el mercado?

    FAQs

    Los subsidios para las primas están disponibles para quienes contratan una cobertura del mercado de seguros y cuyos ingresos son al menos iguales al nivel federal de pobreza. Para una persona, esto significa un ingreso de al menos $15.650 en 2026. Para una familia de cuatro, esto significa un ingreso de al menos $32.150 en 2026. Esta calculadora de subsidios del mercado de seguros puede mostrarle su elegibilidad para diferentes montos de ingresos y tamaños…

  • Who is eligible for Marketplace premium tax credits?

    FAQs

    Premium tax credits are available to U.S. citizens and certain lawfully present immigrants who purchase coverage in the Marketplace and who have income at least as high as 100% of the federal poverty level (FPL) ($15,650 for a single adult or $32,150 for a family of four in 2026). In the past, lawfully present immigrants who made less than 100% of the federal poverty level could also receive help paying premiums and cost-sharing for coverage…

  • I’m covered under my parents’ plan and I’m pregnant. Will my parents’ plan cover my prenatal care and delivery?

    FAQs

    Federal laws require many employer-sponsored plans and all ACA-compliant individual insurance plans, including those available through the Marketplaces, to cover maternity services, including pregnancy, childbirth, and newborn care. Cost sharing may apply to some maternity services. Most private plans also must cover prenatal visits and screenings, folic acid supplements, tobacco cessation counseling and interventions, and breastfeeding services without any cost-sharing because they are considered preventive services. Some health plans are not required to cover all…

  • ¿Qué pasa si quiero dejar mi plan de salud del mercado durante el año?

    FAQs

    Es importante que se comunique con su mercado y con el plan de salud y les informe que ya no necesita cobertura. El enlace que se proporciona aquí ofrece detalles sobre cómo cancelar la cobertura del mercado en los estados que utilizan CuidadoDeSalud.gov. Los mercados de seguros estatales pueden tener su propio proceso para cancelar la cobertura. Si reside en uno de estos mercados, haga clic aquí para acceder al enlace que lo llevará al…

  • My husband would like to get a vasectomy, but when I checked with our insurer, they told me that the plan would cover my sterilization without cost-sharing, but we would have to pay part of the costs fo...

    FAQs

    The ACA requires most private health plans to cover birth control, including sterilization, for women, but they are not required to cover sterilization (vasectomies) for men. However, nine states (CA, IL, MD, NJ, NM, NY, OR, VT, and WA) require certain health plans in those states to cover vasectomies, at no cost to the patient. Check with your insurance plan or state insurance department for more information.

  • ¿Me pueden cobrar primas más altas en el mercado si fumo? ¿Cuentan los cigarrillos electrónicos?

    FAQs

    En la mayoría de los estados, sí. Generalmente, una aseguradora puede cobrarle hasta un 50% más si ha consumido productos de tabaco cuatro o más veces por semana en promedio durante los últimos 6 meses. Esto se denomina recargo por tabaco. Por ejemplo, si la prima para alguien de su edad (antes de aplicar los subsidios) fuera de $200 al mes, si usted consume tabaco, su prima podría aumentar a $300 al mes. Las normas…

  • I am in my early 60s and have signed up for a Marketplace plan so that I have health insurance coverage until I qualify for Medicare at age 65. What happens when I go on Medicare?

    FAQs

    When you turn 65, you should sign up for Medicare and notify your Marketplace plan that you now qualify for Medicare coverage. Your Marketplace coverage will not be cancelled automatically by your plan when you turn 65 and sign up for Medicare, but if you receive premium tax credits to help you pay for your Marketplace plan premium, your eligibility for these tax credits will end when your Medicare Part A coverage starts (people with…