Affordable Care Act

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

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Web Briefing: The California v. Texas Supreme Court Case and Its Implications for the ACA

    Event Date:
    Event

    On Tuesday, Nov. 10, the Supreme Court will hear oral arguments on a legal challenge supported by the Trump administration that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. KFF held an interactive web briefing on Monday, Nov. 9, to share insights about the legal issues in the case and the potential…

  • Insurance Coverage and Viral Suppression Among People with HIV in the United States, 2015-2018

    Feature

    Health insurance coverage and access to care improve health outcomes, including viral suppression, for people with HIV in the United States. Prior research has demonstrated that implementation of the Affordable Care Act (ACA) in 2014 increased coverage among people with HIV and that certain forms of coverage are positively correlated with sustained viral suppression. We provide a 2018 update, the latest nationally representative data in this area, as well as trends over time.

  • Individual Insurance Market Performance in Early 2020

    Issue Brief

    Individual market insurers, on average, remained profitable through the first three months of 2020 as claims costs rose only slightly compared to the same period last year. It is likely that the most significant impacts of the coronavirus on the individual market will not be evident nationally until second or third quarter data are released.

  • The 2020 Presidential Election: Implications for Women’s Health

    Issue Brief

    This brief and side-by-side tables reviews the key health issues that are likely to have a direct impact on women’s health as well as their access to coverage and care, and summarizes the presidential candidates’ stated positions and records on these issues.

  • The ACA Primary Care Increase: State Plans for SFY 2015

    Perspective

    This perspective provides additional information on state plans related to the Affordable Care Act's (ACA) primary care rate increase after the 100% federal financing ends December 31, 2014. The data in this report were collected as part of KCMU’s Annual Medicaid Budget Survey, conducted by Health Management Associates with the support of the National Association of Medicaid Directors,

  • An Update on Coverage for Preventive Services Under the Affordable Care Act

    News Release

    An updated fact sheet from the Kaiser Family Foundation summarizes the latest information on health plan coverage of preventive services under the Affordable Care Act. The fact sheet details the rules that govern when plans are required to cover services without cost-sharing and which services are covered. In addition, the fact sheet summarizes the clarifications issued by the U.S. Department of Health and Human Services on coverage for a number of services including: colon cancer…

  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election. All previous columns by Drew Altman are available online.

  • ACA Advertising in 2014 – Insurance and Political Ads

    Report

    This study analyzes the volume and content of political ads mentioning health care issues that aired in 2014 through Oct. 15, as well as health insurance spots promoting specific insurance products or encouraging enrollment in marketplace plans. It finds that about 14 percent of political ads in all races mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way.