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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

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • New Spanish-Language Cartoon and Calculator to Help Consumers Understand Health Insurance

    News Release

    The Kaiser Family Foundation today released two new Spanish-language tools to help consumers better understand health insurance as they shop for plans during open enrollment for the Affordable Care Act’s marketplaces and in other venues. El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!, is a Spanish version of the five-minute cartoon video Health Insurance Explained – The YouToons Have It Covered, a light-hearted treatment of a difficult and important topic. It breaks down…

  • Health Care and the 2016 Debates

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses the lack of attention to health in the primary debates and last week's Democratic forum in South Carolina.

  • Health Care and the 2016 Debates

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses the lack of attention to health in the primary debates and last week’s Democratic forum in South Carolina. All previous columns by Drew Altman are available online.

  • Patient Cost-Sharing in Marketplace Plans, 2016

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 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).

  • Potential Savings from Actively Shopping for Marketplace Coverage in 2016

    Issue Brief

    This analysis looks at how the premiums for the lowest-cost silver plans in Affordable Care Act (ACA) Marketplaces changed between 2015 and 2016. The analysis examines premiums of the 2015 lowest-cost silver plans (in states that used Healthcare.gov in both 2015 and 2016) for a single 40 year-old adult to see how much these premiums increase in 2016 and whether enrollees could obtain lower premiums by switching plans.

  • In 73 Percent of Counties, Healthcare.Gov Enrollees Could Lower Their Silver Plan Premiums by Comparison Shopping

    News Release

    A new analysis from the Kaiser Family Foundation finds that in 73 percent of counties served by Healthcare.gov, people enrolled in the lowest-cost silver plan this year could save money on premiums by switching to a different silver plan in 2016. In these counties, the silver plan with the lowest premiums in 2015 is no longer the lowest-cost plan in 2016, according to the analysis. If they stay in their current plan, Healthcare.gov enrollees who…

  • Most Americans Report a Personal Connection to Those Who Have Abused Prescription Painkillers; Whites More Likely To Be Affected Than Blacks or Hispanics

    News Release

    Poll Finds 9% Say a Family Member or Close Friend Died of an Overdose; 27% Say Either They or Someone Close to Them Has Been Addicted On the ACA This Month, 45 Percent View the Law Unfavorably and 38 Percent View It Favorably With prescription painkiller abuse garnering more attention from the media and policymakers, the latest Kaiser Family Foundation Health Tracking Poll finds most Americans have a personal connection to the issue. In total,…

  • Data Note: Are Nonprofits Requesting an Accommodation for Contraceptive Coverage?

    Issue Brief

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services, including most contraceptives for women. This policy was at the center of a Supreme Court case brought forward by for-profit corporations (Hobby Lobby and Conestoga) that successfully claimed that the contraceptive coverage requirement violated their religious rights. Last month, the Supreme Court agreed to hear yet another challenge (Zubik v Burwell) to the contraceptive…

  • What’s the Political Power of Those Newly Insured Under Obamacare?

    News Release

      With 17 million people newly-insured since 2014, Drew Altman's latest column for The Wall Street Journal's Think Tank takes a look at whether they will make an impact in the first presidential election since Affordable Care Act enrollment began. All previous columns by Drew Altman are online.