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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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  • Analysis: Individual Market Insurers Experienced Their Best Financial Year under the ACA in 2017, Though Subsequent Political and Policy Changes Complicate the Outlook for Future Years

    News Release

    Insurers in 2017 had their best financial year selling individual market health insurance since the Affordable Care Act began requiring guaranteed access to coverage for people with pre-existing conditions in 2014, though recent political and policy changes create new challenges for insurers trying to succeed in this market, new Kaiser Family Foundation analysis finds. This analysis finds insurers posted their strongest performance in the individual market using two different financial indicators: The average share of…

  • 2019 Premium Changes on ACA Exchanges

    Issue Brief

    This tracker monitors preliminary 2019 premiums in the Affordable Care Act’s marketplaces as insurers file rate information with state regulators. It shows preliminary premium information in a major city in each available state for the lowest-cost bronze plan and “benchmark” silver plan, which is used to determine the size of the premium tax credits available to low- and moderate-income enrollees. The tracker also shows how those premiums are changing from 2018 and what a 40-year-old…

  • New KFF Resource Tracks Proposed 2019 Marketplace Premiums By State

    News Release

    The Kaiser Family Foundation today launched a tracker to monitor preliminary 2019 premiums in the Affordable Care Act’s marketplaces as insurers file rate information with state regulators. Beginning with data from eight states (Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia and Washington) plus the District of Columbia, the tracker shows preliminary premium information in nine major cities for the lowest-cost bronze plan and “benchmark” silver plan, which is used to determine the size of the…

  • Two New Analyses: House COVID-19 Relief Plan Would Temporarily Lower Marketplace Premiums for Millions and More than Offset Short-Term State Costs to Expand Their Medicaid Programs

    News Release

    The House COVID-19 relief proposal would temporarily lower what millions of Marketplace enrollees and uninsured potential enrollees would pay toward premiums and would provide states that have not expanded their Medicaid programs a financial boost that would more than offset their costs initially, two new KFF analyses find. The analyses assess two parts of the House plan aimed at expanding access to affordable health coverage by expanding the Affordable Care Act’s tax credits for people…

  • KFF Tracking Poll: More Than a Third of Americans Say They’ve Struggled to Pay Living Expenses Since December; 6 in 10 Families Hit by COVID Have Lost A Job or Income

    News Release

    Majorities Favor Provisions to Expand Marketplace Tax Credits and Encourage States to Expand Medicaid As Congress considers an additional $1.9 trillion COVID-19 relief plan, more than a third (37%) of Americans say that someone in their household has had trouble paying basic living expenses over the past three months, the latest KFF Health Tracking Poll finds. This includes nearly 1 in 4 (23%) who say they have fallen behind on their credit card bills, and…

  • 2021 Calculator – Before COVID-19 Relief

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2021 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • 2021 Calculadora – Antes COVID-19 Alivio

    Interactive

    Nota: esta calculadora refleja las primas para 2021. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • Updated KFF Calculator Estimates Marketplace Premiums to Reflect Expanded Tax Credits in COVID-19 Relief Legislation

    News Release

    KFF has updated its 2021 Health Insurance Marketplace Calculator to reflect the expanded premium tax credits available to people who purchase their own coverage through their state’s health insurance exchange as passed by Congress in the American Rescue Plan Act and expected to be signed into law soon. The calculator allows users to enter their age, income, family size, and zip code to assess their eligibility for tax credits and how much they can expect…