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The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Web Briefing for Journalists – ACA Cost-Sharing Subsidies: How One Decision Could Disrupt Obamacare Marketplaces

    Event Date:
    Event

    Premiums, insurer choice, and overall stability of 2018 Affordable Care Act (ACA) marketplaces could be affected by decisions from Congress and the Trump Administration on the health law’s cost-sharing reduction provision. With a legal appeal pending on a lawsuit from the U.S. House, the federal government and Congress are in a position to choose whether to continue reimbursing insurers for the subsidies, which were established as part of the ACA to reduce out-of-pocket costs for…

  • Estimates: Average ACA Marketplace Premiums for Silver Plans Would Need to Increase by 19% to Compensate for Lack of Funding for Cost-Sharing Subsidies

    News Release

    A new Kaiser Family Foundation analysis finds that the average premium for a benchmark silver plan in Affordable Care Act (ACA) marketplaces would need to increase by an estimated 19 percent for insurers to compensate for lost funding if they don’t receive federal payment for ACA cost-sharing subsidies. Established by the health law to reimburse insurers for the cost of reducing out-of-pocket costs for lower-income people buying marketplace plans (with incomes from 100% to 250%…

  • Medicaid Family Planning Programs: Case Studies of Six States After ACA Implementation

    Report

    In light of the coverage trends and other ACA-related changes, this paper describes the impact on women and their partners, as well as family planning providers, of the impact of family planning expansion programs under Medicaid. It is based largely on interviews with state officials, providers and consumer advocates in Alabama, California, Connecticut, Illinois, Missouri and Virginia – a cross-section of states in terms of geography, Medicaid expansion status, and implementation of a Medicaid family…

  • Analysis: Insurer Financial Indicators Show Signs of Stabilizing After Transition to ACA Marketplaces

    News Release

    A new Kaiser Family Foundation analysis of key insurer financial indicators suggests that the individual insurance market showed signs of stabilizing in 2016, although profitability remained below the level of performance prior to the opening of the Affordable Care Act’s insurance marketplaces. The new analysis tracks insurer financial performance in the individual market through two key indicators: average medical loss ratios (the share of health premiums paid out as claims) and average gross margins per…

  • Federal Government Could See Net Increase of $2.3 Billion in Costs in 2018 if ACA Cost-Sharing Reduction Payments Eliminated

    News Release

    Ceasing payments for the Affordable Care Act’s (ACA) cost-sharing reduction program could save $10 billion, but cost an additional $12.3 billion in premium tax credits – an estimated net increase of $2.3 billion, or 23 percent, in federal spending on marketplace subsidies – in 2018, if insurers continue to participate in ACA marketplaces, according to a new analysis from the Kaiser Family Foundation. The cost-sharing subsidies, established to reduce out-of-pocket costs for ACA marketplace enrollees…

  • How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare

    Issue Brief

    This brief explains the key AHCA provisions that would reshape the private market to more closely resemble the pre-Affordable Care Act period, and the effects of these changes on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

  • What Challenges Could State Insurance Markets Face Under the House’s American Health Care Act?

    News Release

    A new brief from the Kaiser Family Foundation outlines options for state insurance markets and challenges that states could face under the House’s replacement for the Affordable Care Act (ACA). Passed by the House on May 4 and now under consideration by the Senate, the American Health Care Act (AHCA) would reduce the federal government’s role and resources in providing health insurance coverage – particularly for people with low or moderate incomes -- while expanding…