Home Affordable Care Act Topics

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?

Latest News

More KFF Health News

Stay informed.

Get KFF's latest on the Affordable Care Act

Stay informed.

Get KFF's
latest on the Affordable
Care Act

View the Latest: Affordable Care Act

Filter

List Grid

2,421-2,430 of 2,788 results

  • Poll: Public Says Drug Companies Have More Influence in Washington than the NRA

    News Release

    Democrats Split on Whether to Fix the ACA or Push for a National Health Plan; Few Democratic Voters Say a National Health Plan is Their Top Issue for the Midterms As policymakers weigh strategies to address the high cost of prescription drugs, the latest Kaiser Health Tracking Poll finds that a large majority of the public (72%) view pharmaceutical companies as having too much influence in Washington – more than say the same about the…

  • State and Federal Contraceptive Coverage Requirements: Implications for Women and Employers

    Issue Brief

    Before the ACA was passed, many states had enacted contraceptive equity laws that required plans to treat contraceptives in the same way they covered other services. In addition, since the ACA was passed, a number of states have enacted laws that basically codify in state legislation the ACA benefit rules. This issue brief provides an update on the status of the continuing litigation on the federal contraceptive requirement and explains the interplay between the federal…

  • If Health Insurance Subsidies Are Struck Down, States Will Need Time

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores a practical timetable for state action if the Supreme Court rules in favor of the plaintiffs in King V. Burwell and ponders what Republicans in Congress might do.

  • Medicaid Moving Forward

    Issue Brief

    Medicaid is the nation’s main public health insurance program for people with low incomes, and it is the single largest source of health coverage in the U.S., covering nearly 70 million Americans. Medicaid also finances 16% of total personal health spending in the nation. States design and administer their own Medicaid programs within federal requirements, and states and the federal government finance the program jointly. As a major payer, Medicaid is a core source of…

  • Community Health Centers: A 2013 Profile and Prospects as ACA Implementation Proceeds

    Issue Brief

    Community health centers are an integral part of the health care safety-net, providing access to care for nearly 22 million people in underserved communities. The ACA established trust fund for health center growth, and with increased patient revenues attributable to expanded coverage, health centers’ grant funding to support care of the uninsured can go further. This brief provides a 2013 data profile of health centers; highlights pre-ACA differences between health centers in Medicaid expansion and…

  • Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation

    Issue Brief

    This analysis estimates the range of repayment or refund amounts of the advanced premium tax credits issued to enrollees who experience income volatility between the time of enrollment and tax credit reconciliation. Using a simulation model among all households eligible for advance payments of the premium tax credits under the Affordable Care Act, it estimates that half would owe a repayment while 45 percent would be issued a refund of some or all of premium…

  • New Analysis: Half of U.S. Households Eligible for a Tax Subsidy Under the Health Law Would Owe a Repayment, While 45 Percent Would Receive a Refund

    News Release

    Estimated Average Repayment is $794. Estimated Average Refund is $773. Half of U.S. households eligible for a 2014 tax subsidy under the Affordable Care Act would owe a repayment to the government, while 45 percent would receive a refund, according to estimates from a new analysis by the Kaiser Family Foundation. The analysis – which is a simulation based on historical patterns of income volatility among all households eligible for ACA premium subsidies -- estimates that the…

  • Medicaid and Family Planning: Background and Implications of the ACA

    Issue Brief

    This brief reviews the role of Medicaid in financing and enabling access to family planning services for low-income women; discusses how states have expanded access to these services with Medicaid; and highlights future programmatic challenges in the context of the health care delivery and coverage reforms resulting from the Affordable Care Act (ACA).