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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • Keeping Coverage Continuous: Smoothing the Path between Medicaid and the Exchange

    Event Date:
    Event

    A key challenge for those implementing the reform law is how to manage churning, when people cycle in and out of public programs as their income varies. What approaches are states and the federal government taking to minimize the disruption from churning? Will people be able to keep their provider as they move from Medicaid to private coverage and back? This briefing, sponsored by the Alliance for Health Reform and The Commonwealth, addressed these and…

  • Pulling It Together: Predictions

    Perspective

    I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS.  One reason for this is the lingering effect of the recession.  Employers will have little trouble attracting workers in the…

  • Accountable Care Organizations: A New Paradigm for Health Care Delivery?

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    Event

    The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the arrangements are burdensome and too hard to achieve. This briefing addresses questions raised by the law and the subsequent regulation implementing ACOs, including: How will…

  • A Medicaid Block Grant Would Reduce Federal Spending But Trigger Substantial Cuts in Medicaid Coverage in the States That Would Increase the Uninsured

    News Release

    NEWS RELEASEMay 10, 2011 New State-By-State Analysis Shows House Budget Plan For Medicaid Would Reduce Enrollment By Tens of Millions Of People And Cut Funding For Hospitals And Other Medicaid Services WASHINGTON, D.C. -- Converting Medicaid into a block grant and repealing the health reform law as adopted by the House last month in a party-line vote would trigger major reductions in program spending and enrollment compared to current projections, a shift with big implications…

  • Kaiser Health Tracking Poll — May 2011

    Feature

    Most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and more than half want to see no reductions at all in Medicaid spending. One in five adults has received Medicaid benefits over time, and for most, experiences were positive, although one third of them report having had problems finding a doctor. The findings come at a time of intense public debate in Washington about the future of…

  • Medicaid’s Role for Hispanic Americans

    Fact Sheet

    This fact sheet examines Medicaid's role for Hispanic Americans. It includes data on Medicaid's coverage of Hispanic Americans and the program's impact on their access to care, as well as the impacts of the recent recession and the coming expansion of Medicaid under health reform on enrollment in Medicaid among Hispanic Americans. The fact sheet also has a chart showing state-by-state data on health insurance coverage of Hispanic Americans. Fact Sheet (.pdf)

  • Medicaid’s Role for Black Americans

    Fact Sheet

    This fact sheet examines Medicaid's role for black Americans. It includes data on Medicaid's coverage of black Americans and the program's impact on their access to care, as well as the impacts of the recent recession and the coming expansion of Medicaid under health reform on enrollment in Medicaid among black Americans. The fact sheet also has a chart showing state-by-state data on health insurance coverage of black Americans. Fact Sheet (.pdf)

  • Public Reporting of Quality Outcomes: What’s the Best Path Forward?

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    The Affordable Care Act aims to promote higher quality care in part by rewarding – and eventually requiring – the reporting of certain quality measures. Previous efforts suggest that public reporting can add significant value. Yet there are concerns about the best way to measure outcomes and quality, the possible unintended effects of public reporting, and whether purchasers and consumers actually use the information to make choices. Panelists at this April 27 briefing co-sponsored by…

  • KFF April Tracking Poll: Opinions of Reform Remain Steady

    Perspective

    This month, public opinion on the health reform law continues to be remarkably steady. The April Kaiser Health Tracking Poll finds that four in ten feel favorably about the law and an equal share say they feel unfavorably. In recent months there has been a slight decline in the share with an unfavorable view of the law, with a corresponding uptick in the share who offer no opinion on the law. The rise in those…

  • Today’s Topics In Health Disparities: HHS’ Action Plan to Reduce Health Disparities

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    Event

    Today's Topics in Health Disparities webcast examined the new Department of Health and Human Services’ Action Plan to Reduce Racial and Ethnic Health Disparities. The program addressed the contents of the strategy and its timeline for implementation as well as its implications for providers. The panelists also discussed how the new strategy relates to other recently released HHS strategies including the National Strategy for Quality Improvement in Health Care, the National Prevention and Health Promotion…