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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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  • 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.

  • 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.

  • 2020 Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: esta calculadora refleja las primas para 2020. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: esta calculadora refleja las primas para 2021. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • 10 Reasons to Pay Attention to ACA Open Enrollment in 2020

    Policy Watch

    Whether new to the market or reenrolling, everyone who wants 2021 coverage through the ACA Marketplace must sign up during Open Enrollment. Here, we detail ten ways in which the 2021 ACA open enrollment period differs from enrollment periods in past years.

  • 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…

  • Amid the Coronavirus Crisis, President Trump and Democratic Nominee Joe Biden Offer Widely Different Views on Health Care

    News Release

    President Trump and Democratic nominee Joe Biden hold widely divergent views on health issues, with the president’s record and response to the coronavirus pandemic likely to play a central role in November’s elections. A new KFF side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a wide range of key health issues, including the response to the pandemic, the Affordable Care Act marketplace, Medicaid, Medicare, drug prices, reproductive health, HIV, mental…

  • From the Federal Response to COVID-19 to Ongoing Efforts to Repeal the ACA and Proposals for Lowering Drug Prices, President Trump Has an Extensive Record on Health Care

    News Release

    Since taking office in 2017, President Trump has laid down an extensive record on health care, including his response to the COVID-19 pandemic, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency. President Trump’s record on health care provides a window into…

  • How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options

    Issue Brief

    Under the Affordable Care Act (ACA), states are afforded a number of new and expanded opportunities, including enhanced federal financing, to improve access to and delivery of Medicaid long-term services and supports (LTSS). This policy brief provides an overview of six key Medicaid LTSS options created or enhanced by the 2010 law and state adoption of these options to date. Nearly every state (47 states and DC) has taken steps forward with at least one…