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

2,481-2,490 of 2,788 results

  • What happens after the COBRA subsidies end in September?

    FAQs

    You can continue on COBRA unsubsidized until your 18 months of COBRA eligibility ends. In addition, you will have the option to enroll in marketplace coverage when the subsidy ends in September.  Loss of the COBRA subsidy will make you eligible for a special enrollment period (SEP) to sign up for marketplace coverage.  If you make your plan selection before the end of September, new marketplace coverage will take effect on October 1. 

  • Sources of Payment for Uncompensated Care for the Uninsured

    Issue Brief

    This brief estimates the level of public funding that was paid to help offset providers’ uncompensated care costs for the uninsured in 2017. To conduct the analysis, we rely on several secondary data sources including government budget appropriations and expenditure data for major public programs that provided funds to cover the cost of care for the uninsured, as well as analyses of secondary data sources completed by others.

  • Analysis Estimates 5.1 Million People Fall into the Affordable Care Act’s “Family Glitch”

    News Release

    A new KFF analysis estimates 5.1 million people nationally fall into the Affordable Care Act’s “family glitch” that occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. The so-called glitch occurs because the ACA prohibits people with an offer of affordable employer coverage from purchasing subsidized coverage through the ACA marketplace. Under current rules, the affordability of…

  • Private Insurers Are Expected to Pay $2.1 Billion in Rebates to Consumers This Year for Excessive Health Insurance Premiums Relative to Health Care Expenses

    News Release

    Private insurance companies are expecting to pay out $2.1 billion in rebates to consumers this fall, the second highest amount ever issued under the Affordable Care Act, according to a new KFF analysis. The rebates, which are calculated based on the share of premium revenues that insurance companies paid out for health care expenses and quality improvement, are roughly $400 million lower than last year’s record high of $2.5 billion, but more than 50 percent…

  • Why Drug Price Negotiation Has Staying Power

    From Drew Altman

    In this Axios column, Drew Altman looks beyond Medicare to what’s at stake for employers and workers in the debate about the government negotiating drug prices.

  • The Missing Debate Over Rising Health-Care Deductibles

    From Drew Altman

    In this Wall Street Journal Think Tank column, Drew Altman discusses what may be the most important change in the American health system—hint it’s not the Affordable Care Act—which has occurred without much discussion.

  • 50-State Survey Finds Slower Growth in Total Medicaid Spending Nationally in FY 2016 and Projected for FY 2017 as Earlier Increases from the Affordable Care Act’s Coverage Expansions Taper Off

    News Release

    After record increases in fiscal year 2015, growth in Medicaid enrollment and total Medicaid spending nationally slowed substantially in FY 2016 and are projected to continue to slow in FY 2017 as the initial surge of enrollment under the Affordable Care Act’s coverage expansions tapered off, according to the 16th annual 50-state Medicaid Budget Survey by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.  Despite recent trends, Medicaid officials identified high cost and specialty drugs…