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Affordable Care Act

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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  • Obamacare y Usted: Si tiene Medicare

    Fact Sheet

    Si usted tiene Medicare, su cobertura de salud no tiene cambios como consecuencia del Obamacare. Usted puede seguir confiando en el Medicare para ayudar a pagar su hospital, doctores y otros gastos médicos. Usted todavía tiene la opción de elegir entre el Medicare tradicional o el Medicare Advantage Plan (como un Medicare HMO) ofrecido en su área, y entre otros planes de Medicare para medicamentos recetados. Si usted está en Medicare y tiene bajos ingresos,…

  • Obamacare y usted

    Fact Sheet

    "Obamacare y usted" es una serie de materiales que explican cómo la Ley de Cuidado de Salud a (Affordable Care Act o ACA en inglés), también llamada “Obamacare,” afecta a diferentes grupos de personas. Haga clic en los links de abajo para aprender más: Si no tienes seguro médico Haga clic para leer en inglés / Click here to read this fact sheet in English Si tienes bajos ingresos y puede calificar para Medicaid Haga clic…

  • States’ Participation in Six Key Medicaid Long-Term Services and Supports Options Provided or Enhanced by the Affordable Care Act

    Feature

    States’ Participation in Six Key Medicaid Long-Term Services and Supports Options Provided or Enhanced by the Affordable Care Act Download Source M. O’Malley Watts, M. Musumeci, and E. Reaves, How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options, The Henry J. Kaiser Family Foundation, April 2013, available at: http://www.kff.org/medicaid/issue-brief/how-is-the-affordable-care-act-leading-to-changes-in-medicaid-long-term-services-and-supports-ltss-today-state-adoption-of-six-ltss-options/;  updates available at: http://www.kff.org/state-category/health-reform/.

  • 2023 Calculadora del Mercado de Seguros Médicos

    Interactive

    2023 Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de su familia para obtener un estimado de…

  • Obamacare y Usted: Si usted es una mujer

    Fact Sheet

    Como mujer, es especialmente importante para usted entender cómo la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act o ACA, en inglés) cambiará el cuidado de salud en el 2014. Su atención médica necesita diferenciarse de la de los hombres y a menudo usted es la que toma las decisiones sobre el cuidado de salud de su familia. Obamacare amplía la variedad de muchos servicios que son importantes para las mujeres, y…

  • Implications of the Affordable Care Act for People With HIV Infection and the Ryan White HIV/AIDS Program: What Does the Future Hold?

    Issue Brief

    There are numerous aspects of the Affordable Care Act that will be important for people with HIV in the U.S., -- however, it is unlikely that these changes will address all the needs of people with HIV. The Ryan White HIV/AIDS Program will thus remain crucial for the provision of adequate health care to HIV-infected individuals, but it will need to change. Changes in the Ryan White Program’s role will depend largely on state decisions…

  • Webinar for Journalists: Researching Consumer Stories, Finding New Ideas & Securing Real-World Examples

    Event Date:
    Event

    Featuring Kaiser Health News Staff Writer Sarah Varney and “Insuring Your Health” columnist Michelle Andrews, this webinar will discuss approaches to covering this complex story by incorporating individual examples; provide tips and techniques for digging into the details of the law (with expert help) to describe how its provisions play out in real life; and suggest new angles and under-reported story ideas. Additionally, they will identify upcoming policy deadlines and timelines, and explore how to…

  • Webinar for Journalists: How the Affordable Care Act Affects Baby Boomers and Medicare Beneficiaries

    Event Date:
    Event

    As part of the "Covering Health Reform" series, this webinar focused on the major changes facing older people. The Foundation's Associate Director of the Program on Medicare Policy, Juliette Cubanski and Senior Fellow Karen Pollitz discussed how the Affordable Care Act impacts Medicare benefits and beneficiaries, as well as the ACA's role for baby boomers who are not yet 65 and eligible for Medicare.

  • Data Note: California’s Young Uninsured – A Look at 19- to 34-Year Olds Pre-ACA Rollout

    Poll Finding

    A Data Note based on the Kaiser Family Foundation California Uninsured Baseline Survey In California, as across the United States, the young uninsured are a key piece of the new Affordable Care Act (ACA) marketplace puzzle. Having a good-sized component of young people, with their generally more robust health and less frequent need for medical care and prescription drugs, in the newly created insurance pools would provide an important counterbalance to the incoming group of…