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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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  • Rewarding Healthy Behaviors: Variation in Health Risk Across Industries Among American Workers

    Issue Brief

    Faced with an unsustainable growth in health care costs, both employers and policymakers have begun to consider the potential savings that might be achieved by investments in health promotion and better access to preventive care. There has also been public discussion about the potential of building financial incentives for healthy behaviors and the use of prevention services into health plans. Creating the right incentives is a challenge however, because experience is so limited and healthy…

  • Survey on the Role of Health Care Interest Groups –Toplines

    Poll Finding

    These toplines are of a survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health examines the public’s views and opinions of the role of health care interest groups in the ongoing federal health care debate. The survey examines whether people feel their views are represented in the ongoing legislative process and their level of trust in different groups. The survey is part of a series of projects about…

  • Expanding Medicaid under Health Reform: A Look at Adults at or below 133% of Poverty

    Issue Brief

    This issue brief from the Kaiser Commission on Medicaid and the Uninsured examines the key characteristics of the 17.1 million low-income uninsured adults who currently have incomes that would qualify them for Medicaid under the expansion of the program in health reform. The planned expansion of Medicaid to all individuals with incomes at or below 133 percent of the federal poverty level will establish a national foundation of coverage based on income. Adults whose incomes…

  • Health Center Patient Trends, Enrollment Activities, and Service Capacity: Recent Experience in Medicaid Expansion and Non-Expansion States

    Issue Brief

    In thousands of medically underserved communities across the U.S., community health centers enroll low-income people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and…

  • 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…

  • Survey of Kentucky Residents on State Health Policy

    Poll Finding

    This survey of Kentucky residents gauges their views on health care policy in the state, including their preferences for the future of the Medicaid expansion and the state-based health insurance marketplace, Kynect. Kentucky has received national attention as the only Southern state to fully embrace the Affordable Care Act, though the state elected a new governor in November 2015 who campaigned on rolling back the Medicaid expansion and ending Kynect.

  • Few Uninsured Know Date of Pending Deadline for Obtaining Marketplace Coverage; Many Say They Will Get Coverage Soon, Though Cost is a Concern

    News Release

    Most Democrats Like Medicare-for-All, But Very Few Say the Issue Will Drive Their Votes in the 2016 Elections Similar to Last Month, More Hold Unfavorable Views of the ACA than Favorable Ones The Affordable Care Act's third open enrollment period will end on Jan. 31, but the latest Kaiser Health Tracking Poll finds that only a small share of people without health insurance realize it. Just 7 percent of the uninsured correctly identify January as…

  • Surprise Medical Bills

    Issue Brief

    This brief explores the problem of "surprise medical bills" -- charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.

  • Health Insurance Marketplace Calculator Updated for 2016

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator is now updated to include local data on 2016 health plans that are being sold through the Affordable Care Act marketplaces. The Spanish-language version of the calculator is also updated.