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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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  • ¿Tengo que probar elegibilidad para un período especial de inscripción?

    FAQs

    Sí, en algunos casos. Al solicitar cobertura del mercado y calificar para un período especial de inscripción, el mercado podría solicitar documentos adicionales para confirmar que califica para la cobertura en su aviso de elegibilidad del mercado. Si solicita cobertura del mercado luego de perder otra cobertura, cuidadodesalud.gov le permitirá seleccionar un plan de salud, pero retrasará la fecha de vigencia de la cobertura mientras verifica dicha pérdida. Si el mercado no puede verificar automáticamente…

  • Me acabo de mudar del estado A al estado B. Todavía no tengo una vivienda permanente, me estoy quedando con un amigo hasta que consiga trabajo y me instale, pero necesito seguro de salud ya. ¿Cómo puedo...

    FAQs

    El hecho de que no tenga un hogar permanente no afectaría su elegibilidad en el estado B en tanto usted resida en ese estado y tenga la intención de quedarse. En los estados que usan cuidadodesalud.gov, para calificar para un período especial por mudanza permanente, usted debe haber estado inscripto en otra cobertura mínima esencial, como un plan de salud a través del trabajo, otro plan del mercado o Medicaid, por al menos un día…

  • ¿Cuánto tiempo pasa desde que me inscribo hasta que la cobertura entra en vigencia?

    FAQs

    En la mayoría de los estados, si se inscribe en un plan privado de salud en cualquier momento entre el 1 de noviembre y el 15 de diciembre, y realiza el primer pago de la prima antes de la fecha límite para su plan, su nueva cobertura de salud comenzará el 1 de enero. Si se inscribe después del 15 de diciembre, su cobertura de 2026 comenzará el 1 de febrero. Averigüe con el mercado…

  • ¿Qué es el mercado de seguros de salud?

    FAQs

    Los mercados de seguros (también conocidos como de intercambio) son mercados organizados en donde las personas y familias pueden buscar e inscribirse en un seguro médico en línea, por teléfono o en persona. Estos mercados ofrecen una variedad de planes de salud, certifican los planes participantes y brindan información para ayudar a los consumidores a comprender sus opciones y solicitar cobertura. Hay un mercado de seguros en cada estado. Algunos son administrados por el estado…

  • Consumer Assistance in Health Insurance: Evidence of Impact and Unmet Need

    Issue Brief

    The Affordable Care Act (ACA) established in-person consumer assistance programs to help people identify coverage options and enroll. A variety of professionals provide consumer assistance, including Navigator programs that are funded through state and federal marketplaces, brokers who receive commissions from insurers, local non-profit organizations, and health care providers. In the spring of 2020, KFF surveyed consumers most likely to use or benefit from consumer assistance to learn who uses consumer assistance, why they seek…

  • COVID-19, Mental Health, and the 2020 Election: A Review of Candidate Platforms

    Issue Brief

    This brief examines where the candidates stand on four key aspects of the nation’s mental health and substance abuse challenges: the opioid epidemic, suicide rates, mental health parity, and mental health workforce. On each issue, the brief summarizes the policy positions of President Trump and former Vice President Joe Biden.

  • Coronavirus Response and the Affordable Care Act

    Issue Brief

    This post examines the Affordable Care Act's impact 10 years after its enactment and how its provisions, especially those that expand coverage opportunities, could address the health threat and economic upheaval caused by the coronavirus pandemic.

  • Coronavirus Response and the Affordable Care Act

    Policy Watch

    This post examines the Affordable Care Act's impact 10 years after its enactment and how its provisions, especially those that expand coverage opportunities, could address the health threat and economic upheaval caused by the coronavirus pandemic.

  • Why the U.S. Doesn’t Have More Hospital Beds

    From Drew Altman

    With much of the news focused on the surge capacity of the nation’s hospitals during the COVID-19 pandemic, Drew Altman’s Axios column examines why the nation has a shortage of hospital beds and what can be done about it.