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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

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?

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  • Article and Policy Forum Examine Medicare, Health Reform and the Challenges Facing People With Disabilities

    Event Date:
    Event

    Wednesday, Sept. 8, the Foundation held a policy workshop examining Medicare, health reform and the challenges facing people with disabilities. Younger Medicare beneficiaries with disabilities are much more likely than seniors in the program to report problems accessing and paying for needed medical services, Kaiser Family Foundation researchers report in this Health Affairs article. Based on a national random-sample survey of people on Medicare, the study finds that half of nonelderly disabled beneficiaries report problems…

  • Briefing on State Medicaid Programs, the Recession and Health Reform

    Event Date:
    Event

    The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) held a 9:30 a.m. ET briefing on Thursday, September 30 to examine the challenges facing states as they continue to struggle with the lingering impacts of the recession and begin preparing to implement health reform. Three reports were released at the event: Hoping for Economic Recovery, Preparing for Reform: A Look at Medicaid Spending, Coverage and Policy Trends: Results from a 50-State Medicaid Budget…

  • Health Reform and State Workforce Challenges: An Early Look at Five States

    Report

    This report provides an early look at state efforts to prepare for health reform, examining the experiences to date in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). The report finds that the state political environment and expected leadership transitions create uncertainties and are already factoring into state strategies on health reform implementation. State leaders dealing with an aging workforce, hiring constraints, and the toll from the recession also see a need for additional…

  • Kaiser Health Tracking Poll — September 2010

    Feature

    Six months since the enactment of the Patient Protection and Affordable Care Act and a month and a half before the midterm congressional elections, Kaiser's September Health Tracking Poll finds the public remains divided on the new law. Public confusion over the new health law has risen to its highest point since April. The tug of war for public opinion on health reform continues this month, with approval and disapproval staying in the same relatively…

  • Health Reform Roundtables: Charting A Course Forward

    Report

    Health Reform Roundtables: Charting A Course Forward is a series of discussions among federal officials, state officials and outside experts that provides an opportunity to share insights and explore key issues related to implementing a significant expansion of the Medicaid program as part of the new health reform law that will require most U.S. citizens and legal residents to obtain health coverage. States will be largely responsible for implementing the Medicaid expansion, which will provide…

  • Expanding Coverage to Adults through Medicaid Under Health Reform: Key Issues to Consider for Implementation

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured convened a roundtable discussion on June 23, 2010 with a group of federal and state officials and experts to discuss key issues related to reaching, enrolling and delivering care to adults in Medicaid under health reform. The discussion focused in particular on non-disabled adults without dependent children (often referred to as "childless adults") who have historically been ineligible for the program. When the new coverage goes into…

  • Health Reform and Communities of Color: Implications for Racial and Ethnic Health Disparities

    Issue Brief

    This issue brief examines the key provisions of the 2010 health reform law that will expand health coverage and are likely to improve access to care for people of color, as well as some of the other provisions that will likely have either a direct or indirect impact on health disparities. Issue Brief (.pdf)) Previous Version: November 2009 (.pdf)

  • Support for Health Reform Dips Back to May Levels in KFF August Tracking Poll

    Perspective

    Support for health reform fell over the past month, dipping from a 50 percent favorability rating in July to 43 percent now, while 45 percent of the public reported unfavorable views. The dip in favorability returned public opinion on the new law to the even split last seen in May before a modest uptick in support in June and July. But voters have a lot on their minds besides health reform. Asked what would make…

  • Quality Ratings of Medicare Advantage Plans: Key Changes in the Health Reform Law and 2010 Enrollment Data

    Issue Brief

    NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. This Kaiser Family Foundation issue brief examines the key changes in this year’s health reform law that will reward bonuses to private Medicare Advantage plans based on quality rating. Medicare currently rates plans on a five-star scale, with five stars representing the highest quality. The brief analyzes plans based on their quality rating for the current year and also examines enrollment…

  • New Orleans Residents Say Recovery Is Making Progress, But Many Believe The Gulf Oil Spill Will Be More Damaging Than Katrina

    News Release

    Crime is By Far The Biggest Concern in New Orleans Seven in 10 Residents Say Americans Have Forgotten The City’s Plight African-Americans View Their Recovery Differently; It’s Much Slower MENLO PARK, Calif. -- Five years after Hurricane Katrina, an increasing majority of the city’s residents says the rebuilding process is going well, but substantial majorities still report that the city has not recovered and feel the nation has forgotten them, according to a new comprehensive…