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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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  • ¿Me pueden cobrar primas más altas en el mercado de seguros de salud si fumo?

    FAQs

    En la mayoría de los estados, sí. Generalmente, una aseguradora puede cobrar hasta un 50% más a una persona que consume productos de tabaco. Por ejemplo, si la prima para alguien de su edad (antes de que se apliquen los créditos fiscales) fuera de $200 por mes, si usted es consumidor de tabaco, su prima podría aumentar a $300 por mes. Algunos estados prohíben a las aseguradoras aplicar un recargo por tabaco: California, Connecticut, Distrito…

  • Firearms are the Leading Cause of Death for Children in the United States But Rank No Higher Than Fifth in Other Industrialized Nations

    News Release

    Firearms are now the number one cause of death for children in the United States, but rank no higher than fifth in 11 other large and wealthy countries, a new KFF analysis finds. Guns - including accidental deaths, suicides, and homicides - killed 4,357 children (ages 1-19 years old) in the United States in 2020, or roughly 5.6 per 100,000 children. In each of the peer countries, guns kill fewer children than motor vehicles, cancer,…

  • Marketplace Insurers are Proposing a 6% Average Premium Hike for 2024 and Pointing to Inflation as a Key Driver of Costs

    News Release

    ACA Marketplace insurers are requesting a median premium increase of 6% for 2024, according to a new KFF analysis of the preliminary rate filings. Insurers’ proposed rate changes – most of which fall between 2% and 10% – may change during the review process. Although most Marketplace enrollees receive subsidies and are not expected to face these added costs, premium increases could result in higher federal spending on subsidies. Insurers cite price increases for medical…

  • ¿Quién es elegible para recibir subsidios para las primas?

    FAQs

    Los subsidios para las primas están disponibles para ciudadanos estadounidenses y ciertos inmigrantes con residencia legal que adquieran cobertura en el mercado de seguros y cuyos ingresos sean al menos iguales al 100% del Nivel Federal de Pobreza (FPL) ($15.650 para un adulto soltero o $32.150 para una familia de cuatro) en 2026. Actualmente, los subsidios para las primas también están disponibles para inmigrantes con residencia legal con ingresos inferiores a $15.650 (100% del FPL…

  • ¿Cómo aplico para recibir los subsidios para ayudarme a pagar las primas?

    FAQs

    Comience completando la solicitud de cobertura en línea en cuidadodesalud.gov. Esto podría ser más rápido, aunque también puede enviarla mediante una solicitud impresa por correo postal o llamando al centro de atención telefónica del mercado y solicitando por teléfono. Solicitar en línea es probablemente la opción más rápida. Para solicitar en línea, deberá crear una cuenta personal segura con un nombre de usuario y una contraseña. Haga clic aquí para obtener información sobre cómo configurar…

  • Soy un adulto joven, recién independizado de mis padres, y nunca antes había presentado mi propia declaración de impuestos federal. ¿Puedo solicitar subsidios para las primas este año? ¿Eso generará alg...

    FAQs

    Sí, puede solicitar créditos fiscales para las primas este año. Un desafío que puede enfrentar es verificar sus ingresos. El mercado de seguros verifica los ingresos estimados de un solicitante en tiempo real durante el proceso de solicitud, utilizando datos del IRS de declaraciones de impuestos federales recientes y, a veces, otras fuentes de datos. Sin embargo, dado que nunca antes ha presentado una declaración de impuestos, el mercado debe aceptar su autodeclaración sobre su…

  • The Implications of the Most Recent Challenge to the ACA’s Preventive Care Requirement Could Affect Millions

    News Release

    A new brief explains the implications of the most recent legal challenge contesting the Affordable Care Act’s (ACA) requirement that most private insurance plans cover specific preventive care items and services—such as contraceptive services and supplies, and cancer screenings—at no cost to patients. In Braidwood Management v. Becerra, two Christian-owned businesses and six individuals in Texas have challenged the legality of the preventive care mandates on constitutional grounds. The plaintiffs are also challenging the requirement…

  • Nine Changes to Watch in ACA Open Enrollment 2023

    Policy Watch

    The 2023 Affordable Care Act (ACA) Open Enrollment period will run from November 1, 2022 to January 15, 2023 in most states, longer in some state-based marketplaces. This policy watch examines nine changes that may affect what enrollees pay for coverage, the size of tax credits for those eligible, and other changes that could affect enrollees' experiences.