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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

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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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  • Medicaid in a Time of Growth and Change: Findings from the Annual Kaiser 50-State Medicaid Budget Survey at a Forum with the National Association of Medicaid Directors

    Event Date:
    Event

    The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released its 15th annual 50-state Medicaid budget survey for state fiscal years 2015 and 2016. Kaiser and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss key findings and highlight trends in enrollment and spending as well as policy changes in Medicaid programs around the country.

  • Women’s Health Issues Journal: Medicaid and Women’s Health Coverage Two Years into the Affordable Care Act

    Issue Brief

    As Medicaid marks its 50th year, the program has unquestionably become the mainstay of health coverage for low-income women in the nation. Since its inception, its role for women has continued to evolve and expand, but the passage of the Affordable Care Act (ACA) swung open the doors for Medicaid to serve even more low-income women who lack access to private or employer-based insurance. This is because the ACA enabled states to finally eliminate Medicaid's…

  • Nearly Half of the Uninsured, or 15.7 Million People, Are Eligible for Medicaid or Subsidized Affordable Care Act Coverage, Analysis Finds

    News Release

    State-Level Numbers Provide Estimates of How Many Could Be Reached During Third ACA Open Enrollment Period Weeks away from the Affordable Care Act’s third open enrollment period, a new Kaiser Family Foundation analysis finds nearly half (49% or 15.7 million) of the 32.3 million nonelderly people in the United States without health insurance at the beginning of 2015 are eligible for Medicaid or subsidized coverage through an ACA marketplace. On a state level, the share…

  • Prescription Drug Costs Remain Atop the Public’s National Health Care Agenda, Well Ahead of Affordable Care Act Revisions and Repeal

    News Release

    28% of Public Report Asking Doctor about a Drug They Saw Advertised, and 12% Say Their Doctor Prescribed It Few Workers Expect Raises if Employers Reduce Health Benefits to Avoid Cadillac Tax as Many Economists Predict With some presidential candidates laying out details of their health care platforms, the cost of prescription drugs remains at the top of the public's health care priority list for the President and Congress, the October Kaiser Health Tracking Poll…

  • What Paul Ryan’s Stance on 2016 Means for Health Care

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of Paul Ryan’s decision to rule out being drafted as a Republican presidential candidate for the 2017 health care agenda and how it could focus greater attention on proposals to change Medicare and Medicaid along with the Affordable Care Act.

  • Analysis of UnitedHealth Group’s Premiums and Participation in ACA Marketplaces

    Issue Brief

    This analysis looks at how a potential withdrawal by UnitedHealth Group from the Affordable Care Act (ACA) marketplaces in 2017 could impact insurer competition and premiums, finding a significant impact in some markets, though it would have a minimal effect on the average benchmark premium nationwide, The impacts of a UnitedHealth withdrawal would vary considerably by state and market area, with a more pronounced effect in rural areas. Since UnitedHealth often is not one of…

  • Two Year Trends in Medicaid and CHIP Enrollment Data: Findings from the CMS Performance Indicator Project

    Issue Brief

    This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight…