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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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  • Kaiser Health Tracking Poll — September 2009

    Feature

    The September Kaiser Health Tracking Poll finds that public support for health reform ended its summer slide, reversed course and moved modestly upwards in September. The survey also finds initial majority support for taxing expensive health plans and imposing fees on insurers to pay for reform. Fifty-seven percent of Americans now believe that tackling health care reform is more important than ever—up from 53 percent in August. The proportion of Americans who think their families…

  • Key Findings: Kaiser Health Tracking Poll — July 2009

    Poll Finding

    This document contains the key findings from the July Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted July 7 through July 14, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (800) and cell phone (405, including 126 who had no landline telephone) were carried out in English and Spanish. The margin…

  • A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage

    Issue Brief

    This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. The brief examines the history of earlier experiences and provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable…

  • Kaiser Health Tracking Poll: Early Reaction to Supreme Court Decision on the ACA

    Feature

    This poll fielded following the Supreme Court’s decision upholding the heart of the Affordable Care Act (ACA) finds a majority of Americans (56 percent) now say they would like to see the law’s detractors stop their efforts to block its implementation and move on to other national problems. Democrats overwhelmingly say opponents should move on to other issues (82 percent), as do half (51 percent) of independents and a quarter (26 percent) of Republicans. But,…

  • Seniors and the 2012 Presidential Election

    Feature

    This data note draws primarily on two national surveys, the September Kaiser Health Tracking Poll and the Kaiser 2012 National Survey of Seniors, to examine how health issues are playing as a 2012 election issue for seniors, how this politically important group feels about a variety of policy proposals related to Medicare, including the premium support model, and seniors' views of the 2010 Affordable Care Act (ACA). Data Note (.pdf)

  • Pulling It Together: The Falloff in Utilization: “There’s Something Happening, Here, What It Is Ain’t Exactly Clear”

    Perspective

    For as long as I have been in the field, we have seen cycles in health care costs. Per capita health spending would rise, then moderate, then rise gain. My colleague Larry Levitt and I documented this in The Sad History of Health Care Costs and my friend Dr. Jim Mongan called it “the peaks and valleys” of health care costs. We have never been sure whether the "valleys" were the result of government actions, such…

  • Kaiser Health Tracking Poll — June 2011

    Feature

    The June Kaiser Health Tracking Poll examines the opinions of seniors and the public about Medicare and the federal budget deficit, a topic of heightened interest these days as policymakers in Washington focus on ways to bring down Medicare spending as part of efforts to reduce the deficit. The poll also provides an early look at the views of registered voters and the potential role health care might play in the upcoming presidential election cycle.…

  • Kaiser Health Tracking Poll — March 2011

    Feature

    Little has changed since President Obama signed the Patient Protection and Affordable Care Act (ACA) into law. The March Health Tracking Poll finds that the public continues to report that they are confused about the law, say they don’t have enough information on how the law will affect them, and remain divided in their views of the law. Further, the stark partisan gap persists. In terms of next steps for the law, Americans like the…

  • Five Key Questions About Medicaid And Its Role in State/Federal Budgets and Health Reform

    Report

    This fact sheet highlights key issues about Medicaid, including the structure, financing and purpose of the program, its role for low-income beneficiaries, its share of the federal budget and state budgets, and the significant implications of the coverage expansion under the Affordable Care Act. Fact Sheet (.pdf) Related chartpack: Five Key Questions And Answers About Medicaid

  • Explaining Health Reform: Building Enrollment Systems That Meet The Expectations of the Affordable Care Act

    Issue Brief

    The new health reform law will require most U.S. citizens and legal residents to have health coverage by 2014. It provides new options for coverage by expanding Medicaid eligibility to more low-income people and creating a state-based system of health insurance Exchanges through which individuals can purchase coverage, with federal subsidies for many. The success of the law in achieving near-universal health coverage will depend on the effectiveness of the enrollment and renewal processes that…