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Affordable Care Act

The Enhanced Premium Tax Credits

Health Insurance Premiums

ACA Marketplace Plans Nationally Are Seeking a Median 18% Premium Increase for 2026

This analysis of insurers’ initial rate filings for Affordable Care Act Marketplace plans in all 50 states and DC finds the median proposed increase for 2026 is 18%, more than double last year’s proposed increase. The analysis also shows proposed rate changes by state and insurer.


How Much Premiums are Going up for Small Businesses in 2026

Tariffs Are Driving up Premiums for Small Businesses

How an ACA Premium Spike Will Affect Family Budgets, and Voters

Calculate How Much More You'd Pay Without the Enhanced ACA Credit

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  • A Look at State Efforts to Ban Cellphones in Schools and Implications for Youth Mental Health

    Issue Brief

    Education leaders and policymakers are turning to cellphone bans in schools to help address youth mental health concerns and improve learning, an idea that has largely received bipartisan support. Cellphone ban legislation has had a resurgence following advisories from the U.S. Surgeon General on youth mental health and the impacts of social media. Research on the effectiveness of these bans, however, is limited, and challenges with implementation and enforcement remain.

  • Enrollment Growth in the ACA Marketplaces

    Policy Watch

    This analysis of enrollment in Affordable Care Act (ACA) Marketplace health plans finds a record 24.3 million people enrolled in 2025, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election. In six states, enrollment more than tripled from 2020 to 2025: Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee.

  • 5 Key Facts About Medicaid Expansion

    Issue Brief

    This issue brief examines Medicaid expansion enrollment and Medicaid spending in expansion and non-expansion states and describes the characteristics of adults covered by the Medicaid expansion.

  • The Spotlight Is on Medicaid Cuts, But the ACA Marketplaces Could See a One-Third Cut in Enrollment

    From Drew Altman

    In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”

  • How the Trump Administration and Congress Are Reshaping the Affordable Care Act’s Marketplaces: Views from the States

    Event Date:
    Event

    Through regulations and the House budget reconciliation bill, significant changes are being considered by Congress and the Trump Administration for how the Affordable Care Act’s health insurance Marketplaces would work. To examine how these changes could reshape the ACA’s Marketplaces, KFF held a virtual briefing on June 11 featuring leaders from two state-based Marketplaces to get perspectives from the field.

  • Making the Marketplaces Great Again?

    From Drew Altman

    In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."

  • How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?

    Issue Brief

    This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10M in 2034 and rise to over 14M if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.

  • How an ACA Premium Spike Will Affect Family Budgets, and Voters

    From Drew Altman

    In his latest column, President and CEO Dr. Drew Altman shows how spiking premiums, which may come if the enhanced ACA tax credits are not extended, will hit people in the context of their family budgets, alongside rising costs for food, housing and utilities. For some families, their new health care costs could far exceed what they pay for food, affecting their economic security and potentially their vote.

  • About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

    Issue Brief

    This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.