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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  • Workplace Wellness Programs Characteristics and Requirements

    Issue Brief

    This issue brief summarizes what’s known about workplace wellness programs offered by employers today and the use of financial incentives to encourage workers to participate. Findings are drawn from the KFF/HRET Annual Employer Health Benefits Survey. In addition, the brief reviews proposed changes by the Equal Employment Opportunity Commission (EEOC) in federal standards governing financial incentives by workplace wellness programs and how these changes might balance the use of incentives against other discrimination and privacy…

  • Data Note: Predictors Of Positive And Negative Attitudes Towards The ACA Among Non-Group Insurance Enrollees

    Poll Finding

    One of the groups perhaps most affected by changes brought about by the Affordable Care Act (ACA) are people who purchase their own health insurance in the non-group market. In this Data Note, we examine data from the Kaiser Family Foundation Wave 2 Survey of Non-Group Health Insurance Enrollees to explore the characteristics of non-group enrollees that are associated with positive and negative attitudes towards the ACA, including feeling personally benefited or negatively affected by…

  • Facing the Fallout From a King v. Burwell Ruling

    From Drew Altman

    With a Supreme Court decision on King v. Burwell looming, this Drew Altman column for The Wall Street Journal’s Think Tank plays out the politics of a ruling for the two major parties.

  • Analysis Examines How Gaining Health Coverage Affected Consumers’ Lives in 2014

    News Release

    An analysis of a 2014 survey by the Kaiser Family Foundation finds that previously uninsured Americans who obtained health coverage that year experienced improved access to care and a decrease in financial insecurity, though they remained concerned about cost.  The analysis of the 2014 Kaiser Survey of Low-Income Americans and the ACA finds that about 11 million previously uninsured nonelderly adults obtained health coverage during 2014, the year the ACA’s new coverage options were fully…

  • After King v. Burwell Ruling, Health Law Issues Involve Implementation

    News Release

    After today’s Supreme Court ruling upholding the Affordable Care Act’s federal subsidies, Drew Altman's latest column in The Wall Street Journal's Think Tank explores what the decision means and what’s next for the health law. All previous columns by Drew Altman are available.

  • Renewals in Medicaid and CHIP: Implementation of Streamlined ACA Policies and the Potential Role of Managed Care Plans

    Issue Brief

    This brief reviews the new renewal requirements for Medicaid and CHIP that are designed to maintain continuity of coverage for eligible individuals. It provides an overview of state implementation of the new renewal policies and considers the potential role managed care plans can play in supporting renewals. Key findings include: some aspects of the simplified renewal policies have not yet been fully implemented due to a range of challenges; some states, including Washington and Rhode…

  • Kaiser Health Tracking Poll: Late June 2015 – A Special Focus On The Supreme Court Decision

    Feature

    The latest Kaiser Health Tracking Poll finds that when told that the U.S. Supreme Court ruled to keep the Affordable Care Act (ACA) as it is, allowing subsidies to be provided to low- and moderate-income people in all states regardless of who runs their Marketplace, about 6 in 10 say they approve of the decision while about a third disapprove. The King v. Burwell ruling does not appear to have had an immediate effect on…

  • Poll Finds 62% of Americans Approve of the Supreme Court’s Decision to Continue Allowing ACA Health Insurance Subsidies in All States, While 32% Disapprove

    News Release

    Public’s View of the Health Care Law Remains Nearly Evenly Divided Immediately Following King v. Burwell Ruling Nearly Eight in 10 Americans Expect More Major Battles about the ACA in the Future Just over six in 10 Americans (62%) say they approve of the U.S. Supreme Court’s decision last week to continue allowing low- and moderate-income people in all states to be eligible for government subsidies to buy health plans through Affordable Care Act (ACA)…