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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…

  • Un aviso de mi aseguradora indica que mi plan no se volverá a ofrecer el próximo año. ¿Ahora que hago?

    FAQs

    Durante la inscripción abierta, puede buscar un plan diferente. Debe inscribirse para obtener una nueva cobertura durante la inscripción abierta para permanecer asegurado el próximo año y recibir el crédito fiscal para ayudar a pagar sus primas lo más preciso posible. Si no actúa antes de que finalice la inscripción abierta y vive en un estado que utiliza cuidadodesalud.gov, el mercado lo inscribirá automáticamente en un nuevo plan. El mercado intentará elegir el plan de…

  • ¿Los planes Medicare Advantage, los planes de medicamentos de la Parte D de Medicare o las pólizas Medigap se venden a través del mercado de seguros de salud?

    FAQs

    No. Los planes Medicare Advantage (como Medicare HMO y PPO), los planes de medicamentos recetados de la Parte D de Medicare y las pólizas Medigap no se venden a través de los mercados federales o estatales. Puede inscribirse en un plan Medicare Advantage o un plan Medicare Parte D en el sitio web de Medicare (www.Medicare.gov) o registrándose directamente con la compañía que ofrece el plan. Para obtener más información sobre sus opciones de cobertura…

  • What to Watch in the 2024 ACA Open Enrollment

    Policy Watch

    With the start of the 2024 Affordable Care Act open enrollment, the Marketplaces have been operating for a full decade and are heading into their eleventh year. This policy watch outlines changes to watch out for during 2024 Open Enrollment.

  • As Open Enrollment Begins, KFF’s Updated Subsidy Calculator and 300+ FAQs Demystify ACA Marketplaces

    News Release

    A recent KFF survey found one-in-three people with Marketplace coverage say it is somewhat or very difficult to find a plan that meets their needs. With ACA enrollment beginning November 1, KFF has updated its most-used Marketplace tools and published an explainer on key changes and issues to watch in this year’s open enrollment season. Tools for Open Enrollment>> KFF’s Health Insurance Marketplace Calculator provides estimates of 2024 health insurance premiums and subsidies for people…

  • 10 Million Have Been Disenrolled from Medicaid; Some Could Find Themselves Eligible for Marketplace Subsidies

    News Release

    More than 10 million people have been disenrolled from Medicaid, based on data available from 50 states and the District of Columbia as of November 1, 2023. Disenrollment rates range from 65% in Texas to 10% in Illinois, according to KFF’s ongoing tracking. Differences in state renewal policies and system capacity likely explain some of this variation. Some disenrolled individuals are regaining Medicaid coverage. As a result, overall declines in Medicaid enrollment will be less…

  • KFF Health Tracking Poll May 2024: Voters’ Views of Health Policy Issues in Context of Presidential Campaigns

    Feature

    Voters are split largely along partisan lines in terms of who they trust in regard to various health care issues, but Biden captures more than Trump trust from Independent voters. Biden is also more trusted by older adults when it comes to entitlement programs. Voters are still largely unaware of the drug pricing provisions of the Inflation reduction Act. Large majorities of voters, particularly Democratic voters, support a federal right to abortion.

  • The American Health Care Act: New House GOP Bill Summary and Interactive Maps of Its Effects on Tax Credits

    News Release

    The Kaiser Family Foundation today issued a summary of the Republican House leadership’s March 6 proposed Affordable Care Act (ACA) replacement bill, the American Health Care Act, that can be compared in 17 key policy areas to the ACA and several other proposed replacement plans. In addition, the Foundation updated its interactive maps that compare county-level estimates of premium tax credits consumers would receive under the Affordable Care Act (ACA) in 2020 with what they’d receive…