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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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  • ACA Open Enrollment Matters for Medicaid Coverage, Too

    Policy Watch

    President Biden’s January 28th executive order to reopen enrollment in the federal ACA Marketplace from February 15 through May 15, combined with $50 million in federal spending on outreach and education about ACA coverage options, has the potential to reach millions of people who were uninsured prior to or have lost coverage during the pandemic. As of 2019, there were 29 million non-elderly uninsured people, and the majority (57%) were eligible for financial assistance through…

  • 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…

  • Survey: OBGYNs Report That the Affordable Care Act Has Increased Use of Contraceptives Among Patients, but the Cost of Reproductive Health Care Still a Burden for Their Low-Income Patients

    News Release

    This report highlights key findings from the 2020 KFF National Physician Survey on Reproductive Health that asked a nationally representative sample of OBGYNs practicing in the United States about a wide range of issues, including their provision of contraception, abortion, and STI care.

  • 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…

  • Web Briefing for Journalists: Consumer Issues Ahead of the Affordable Care Act’s Second Open Enrollment Season

    Event Date:
    Event

    The Affordable Care Act's second annual open enrollment period starts Nov. 15 and runs until Feb. 15 -- a three-month window for Americans to shop for and purchase new health coverage, or change their plan through Healthcare.gov or their state-run insurance marketplace.  This year's open enrollment season poses both new and recurring challenges for consumers:  How are premiums for marketplace plans changing, and what do the changes mean for consumers?  Why might current marketplace customers…

  • Explaining the 2015 Open Enrollment Period

    Issue Brief

    The brief provides an overview of what consumers can expect during the second annual Open Enrollment period under the Affordable Care Act (ACA), which runs from November 15, 2014 through February 15, 2015. It is the second opportunity for uninsured individuals to enroll in private insurance coverage, premium tax credits and cost sharing subsidies and the first time that people newly insured in 2014 can renew their health plan coverage and subsidies. It also overlaps…

  • What to Expect From the Next Congress on the ACA

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explains how Republican control of Congress will likely bring challenges to the Affordable Care Act in two flavors.

  • Updated FAQs Provide New Answers as the Affordable Care Act’s Marketplace Enters Its Second Year

    News Release

    Today, the Kaiser Family Foundation released an updated collection of Frequently Asked Questions (FAQs) providing detailed answers for consumers, and the navigators and brokers who assist them, as the Nov. 15 start date nears for the Affordable Care Act's second open enrollment period. The searchable collection includes nearly 300 up-to-date responses, answering new questions about plan renewal, cancellations, and continuing financial assistance. The FAQs also offer guidance for understanding 2014 federal income taxes in the…

  • Kaiser Calculator Now Gives Consumers 2015 Zip Code-Specific Premium and Tax Credit Estimates for Marketplace Coverage

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator now includes zip code-specific data on 2015 health plans that are being sold through the Affordable Care Act’s insurance marketplaces during the open enrollment period beginning Saturday, Nov. 15. With the new tool, consumers around the nation can generate estimates of their health insurance premiums and government subsidies for 2015 plans that they purchase on their own through an ACA marketplace. The estimates are based on zip…

  • Change in Benchmark Silver Premiums, 2014 – 2015

    Feature

    Change in Benchmark Silver Premiums 2015 MAP_HI_and_MA.ppt Download Source Kaiser Family Foundation analysis of data from Healthcare.gov and insurer rate filings to state regulators. For more information see  “Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces” Sept. 2014.