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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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  • Some Can Get Marketplace Plans With No Premiums,Though With Higher Deductibles and Cost-Sharing

    News Release

    Many low-income consumers who are eligible for federal financial help under the Affordable Care Act can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis from KFF (the Kaiser Family Foundation). Such plans come with higher deductibles and out-of-pocket maximums, however. The analysis finds that the ACA’s premium tax credits would cover the full premium of the lowest-cost bronze…

  • Bipartisan Majorities Support Trump Administration’s Push to Get Drug Prices in Advertisements, Even after Hearing Counter-Arguments

    News Release

    Only 1 in 4 Potential Marketplace Customers Know When ACA Open Enrollment Ends; 1 in 5 Say They Would Buy a Short-Term Plan A large majority of the public backs the Trump Administration’s initiative to require prescription drug advertisements to include information about prices, but fewer support other administrative actions involving pre-existing conditions and contraception coverage, the latest KFF Health Tracking Poll finds. Requiring drugmakers to include price information in their advertisements is a widely…

  • Medicare for All is a Double-Edged Sword for Democrats

    From Drew Altman

    In an Axios column, Drew Altman analyzes the political pros and cons of Medicare for All and Medicare buy-in plans for Democrats, and how they may handle it in Congress and the presidential campaign.

  • New Rules for Section 1332 Waivers: Changes and Implications

    Issue Brief

    On October 22, 2018, the Trump administration released new guidance on Section 1332 waivers established by the Affordable Care Act (ACA). The new guidance may encourage states to use 1332 waiver authority to make broader changes to insurance coverage for their residents, including to promote the sale of, and apply subsidies to, ACA non-compliant policies. On November 29, 2018, the Centers for Medicare and Medicaid Services (CMS) released a discussion paper outlining a set of…

  • Poll: Public Says Drug Companies Have More Influence in Washington than the NRA

    News Release

    Democrats Split on Whether to Fix the ACA or Push for a National Health Plan; Few Democratic Voters Say a National Health Plan is Their Top Issue for the Midterms As policymakers weigh strategies to address the high cost of prescription drugs, the latest Kaiser Health Tracking Poll finds that a large majority of the public (72%) view pharmaceutical companies as having too much influence in Washington – more than say the same about the…

  • Brief Examines Efforts to Create Health Plan Options that Don’t Comply with the Affordable Care Act’s Rules

    News Release

    Though Congress last year failed to repeal key Affordable Care Act requirements for non-group health insurance that people buy themselves, the Trump Administration and some states are promoting other types of plans through regulatory changes that would allow the sale of products that skirt many of the ACA’s requirements. A new Kaiser Family Foundation brief examines four of those options and the tradeoffs involved if such loosely regulated markets take root as an alternative to…

  • I like my Marketplace plan just the way it is. Will it stay the same next year?

    FAQs

    It depends. Insurers are allowed to make changes to plans each year. Most likely, the premium for your current policy will change next year. There may be other changes as well such as the deductible or copays. In some cases, an insurer may stop offering a particular plan and offer you new choices, instead. Shortly before Open Enrollment begins, you should receive a notice from your insurance company describing any changes to your plan and…

  • Can I be charged more because of my age?

    FAQs

    Yes, in most states, you can be charged more based on your age, but within certain limits. For example, older adults in their sixties can be charged up to three times more than younger adults (e.g., in their early twenties). Some states have established lower limits or a complete prohibition on “age rating,” a federal policy that applies to all individual health insurance plans and those offered by fully-insured small employers, whether sold on or…