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How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

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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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  • California and Texas: Section 1115 Medicaid Demonstration Waivers Compared

    Fact Sheet

    This fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010. Both waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will…

  • Webcast: New CMS Estimates of State-by-State Health Expenditures

    Event Date:
    Event

    The Kaiser Family Foundation held a live interactive webcast on December 7, 2011, to discuss trends in state health care expenditures and the implications for national and state efforts to constrain health care costs. The webcast examines new state-by-state estimates of public and private health spending from the Centers for Medicare and Medicaid Services (CMS) published in the online journal, Medicare and Medicaid Research Review. An expert panel offers perspectives on the trends within and…

  • Pulling it Together: The Most Popular Provision in the ACA?

    Perspective

    In our most recent monthly tracking poll, we asked the American people what elements of the health reform law they like and dislike. Surprisingly, the runaway favorite was a relatively obscure requirement that health plans provide consumers with a short, easy to understand description of their benefits and coverage. Sixty percent of the American people gave this requirement for greater transparency in health insurance benefits a very favorable rating, the only provision in the law…

  • Kaiser November Health Tracking Poll: Individual Elements of the ACA Popular with the Public

    Perspective

    After taking a negative turn in October, the public’s overall views on the Patient Protection and Affordable Care Act (ACA) returned to a more mixed status this month. Still, Americans remain somewhat more likely to have an unfavorable view of the law (44 percent) than a favorable one (37 percent). The Kaiser Family Foundation's November Health Tracking Poll also finds that individual elements of the law are viewed favorably by a majority of the public. The law’s…

  • Kaiser Health Tracking Poll — November 2011

    Feature

    The November Health Tracking Poll takes a closer look at public opinion and knowledge about specific provisions of the Patient Protection and Affordable Care Act (ACA). Findings include: After taking a negative turn in October, the public's overall views on the ACA returned to a more mixed status this month. Still, Americans remain somewhat more likely to have an unfavorable view of the law (44%) than a favorable one (37%). The survey also finds that…

  • Financial Alignment Models for Dual Eligibles: An Update

    Issue Brief

    The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design contracts to 15 states to develop service delivery and payment models to integrate care for dual eligibles. CMS and the participating states have recognized that…

  • Kaiser Health Tracking Poll: Support for Health Reform Law Dips in October

    Perspective

    After remaining roughly evenly split for most of the last year and a half, this month’s tracking poll found a higher share of the public expressing negative views towards the health reform law. About half (51 percent) say they have an unfavorable view of the Patient Protection and Affordable Care Act (ACA), while 34 percent have a favorable view, a low point in Kaiser polls since the law was passed. While Democrats continue to be substantially…

  • Questions About Essential Health Benefits

    Perspective

    The Institute of Medicine (IOM) recently issued its long-awaited report on defining the essential health benefits under the Affordable Care Act (ACA). As expected, the committee preparing the IOM report did not recommend which specific services should be covered, but rather discussed what the process should be for defining the essential benefits, which all insurers selling coverage to individuals and small businesses will have to provide beginning in 2014. Somewhat unexpected was their recommendation to set a…

  • State Exchange Profiles: Texas

    Other Post

    Final update made on December 11, 2012 (no further updates will be made) Establishing the Exchange On July 9, 2012, Governor Rick Perry (R) announced that Texas would not establish an exchange.1 Prior to this announcement, the Department of Insurance and the Health and Human Services Commission had partnered to explore exchange implementation plans.2 Using federal grant funding they identified subcontractors to assist with the exchange planning process, to collect stakeholder feedback, and to investigate the state’s…

  • State Marketplace Profiles: Kentucky

    Other Post

    Final update made on November 11, 2013 (no further updates will be made) Establishing the Marketplace On July 17, 2012, Governor Steven L. Beshear (D) issued Executive Order 587 establishing the Kentucky Health Benefit Exchange (KHBE) after the Supreme Court ruled to uphold the Affordable Care Act (ACA).1  In May 2013, the state announced that its online Marketplace would be called kynect. Prior to the Executive Order, the Kentucky Cabinet for Health and Family Services led Marketplace…