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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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  • Pulling it Together: REPOR(t)

    Perspective

    In today’s column I investigate a somewhat lighter topic than my last column on micro-simulation modeling: What was the impact of shows like Jon Stewart’s The Daily Show and Stephen Colbert’s The Colbert Report on the health reform debate?  Who among us has not wondered about the answer to this question?  Please don’t answer that. I should start by acknowledging that I am a frequent but not religious viewer of these shows, and believe that…

  • Medicaid Coverage and Spending in Health Reform: National and State-By-State Results for Adults at or Below 133% FPL

    Report

    This analysis, performed by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, shows that the expansion of Medicaid under the health reform law will significantly increase the number of people covered by the program and reduce the uninsured in states across the country, with the federal government picking up the vast majority of the cost. The analysis is among the first to show for all 50 states and the District of…

  • Real Industry Action on Health Reform?

    Other Post

    The Washington Post published an op-ed authored by Foundation President and CEO Drew Altman which examines how the health industry's voluntary commitment to curb health care spending is similar and different from past efforts. Read the Article

  • Survey Brief: Economic Problems Facing Families

    Poll Finding

    This poll finds that health care costs rank among Americans’ top personal economic problems, and their struggles to deal with those costs have affected both their financial well-being and their family’s health care. Conducted by the Foundation’s public opinion researchers, the poll probes into the economic concerns facing Americans and the ways they have dealt with the cost of health care. The poll was designed and analyzed by public opinion researchers at the Kaiser Family…

  • Governors’ Budgets for FY 2013 — What is Proposed for Medicaid?

    Issue Brief

    This report provides Medicaid highlights from governors' proposed state budgets for FY 2013, which starts July 1, 2012 for most states. While some states are beginning to see signs of economic recovery, many remain cautiously optimistic as they continue to experience the recession's lingering effects. State revenues have not rebounded to pre-recession levels, unemployment rates are still high, and some states continue to face budget shortfalls. There continues to be high demand for Medicaid and…

  • Kaiser Health Tracking Poll — January 2012

    Feature

    As the Supreme Court prepares to hear legal challenges to the health reform law in March, most Americans expect the Justices to base their ruling on their own ideological views rather than their interpretation of the law, according to the January Health Tracking Poll. Other key findings include: The public doubts the Supreme Court renders judgments based solely on the law. Three-quarters (75%) say they think that, in general, Justices let their own ideological views…

  • 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…

  • Kaiser Health Tracking Poll — June 2010

    Feature

    The start of summer finds Americans remain divided on the health reform law, but favorable views of the new law increased seven percentage points over the past month to 48 percent, compared to 41 percent who have “generally unfavorable” views and 10 percent who have yet to make up their minds. With four months remaining until the midterm congressional elections, an early look suggests that the contests could be impacted by a number of different…

  • The Community Living Assistance Services and Supports (CLASS) Act

    Issue Brief

    This issue brief provides a brief overview of the Community Living Assistance Services and Supports (CLASS) Act, including a discussion of how the program would be financed and whom it is intended to reach. The paper was released as part of a Kaiser briefing about the act, a component of two leading health reform bills that would establish a national voluntary insurance program to allow for voluntary pre-financing of long-term care through payroll deductions and…

  • Key Findings: Kaiser Health Tracking Poll — September 2009

    Poll Finding

    This document contains the key findings from the September Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted September 11 through September 18, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 147 who had no landline telephone) were carried out in English and Spanish. The margin…