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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

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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  • Medicare Advantage: Take Another Look

    Perspective

    This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).

  • Those Long Lines To Enroll In The ACA

    News Release

    In the latest post from the series Policy Insights, Kaiser Family Foundation President and CEO Drew Altman discusses the need for community based outreach to enroll the long term uninsured. All previous Policy Insights posts are archived online. The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people. The Foundation…

  • The Next Big Health-Care Issue

    From Drew Altman

    Drew Altman, in The Wall Street Journal‘s Think Tank, writes that the next big concern for the Affordable Care Act (ACA) will be how much premiums increase in exchanges for 2015. He discusses the factors to focus on to put this issue in perspective when states report premium increases.

  • FAQs: What’s the Latest on IPAB?

    Issue Brief

    The Independent Payment Advisory Board was authorized by the Affordable Care Act to help slow the growth in Medicare spending. These FAQs address common questions about IPAB, including how it was designed to operate and the implications of eliminating it.

  • New Individual Mandate Penalty Calculator Helps Consumers Estimate Their Penalty for Being Uninsured in 2018

    News Release

    A new individual mandate penalty calculator from the Kaiser Family Foundation allows consumers to estimate how much they would owe as a tax penalty for lacking health coverage in 2018, and to compare that amount to the cost of the least expensive 2018 Affordable Care Act marketplace plan in their local area. Using household income, family size, ages of family members, and zip code data, the tool provides a projection of an individual’s penalty for…

  • ANALYSIS: More than Half of Uninsured People Eligible for Marketplace Insurance Could Pay Less for Health Plan than Individual Mandate Penalty

    News Release

    A new Kaiser Family Foundation analysis finds that more than half (54% or 5.9 million) of the 10.7 million people who are uninsured and eligible to purchase an Affordable Care Act marketplace plan in 2018 could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

  • How the Elections Could Put the Brakes on Anti-ACA Plans

    From Drew Altman

    In this Axios column, Drew Altman examines the role of health care in Virginia's elections and the referendum on Medicaid expansion in Maine. His assessment: the elections and the referendum will have a bigger impact on upcoming policy debates about cutting Medicaid to pay for tax cuts, and state interest in Medicaid expansion, than on upcoming elections. 

  • Kaiser Health Tracking Poll – November 2017: The Role of Health Care in the Republican Tax Plan

    Feature

    As Republicans in Congress continue efforts to pass tax reform, the November Kaiser Health Tracking Poll examines views of the plans and how they relate to health care issues. Overall, reforming the tax code is seen as a “top priority” for President Trump and Congress by about three in ten (28 percent), falling well-behind several health care issues such as reauthorizing funding for the State Children’s Health Insurance Program (CHIP) (62 percent) and stabilizing the…

  • Poll: Ahead of House Tax Reform Vote, Americans are More Likely to Rank Children’s Health Care, Hurricane Relief and Other Issues as Top Priorities for Washington

    News Release

    Most of the Public Initially Favors Getting Rid of the ACA’s Individual Mandate As Part of Tax Reform, But Some Become Opponents When Presented with Facts and Arguments for Keeping the Mandate As the House prepares to vote Thursday on its tax reform bill, a new Kaiser Family Foundation poll finds almost three in 10 Americans (28%) view tax reform as a top priority for President Trump and Congress. That’s significantly fewer than the share…