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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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  • ¿Cómo funciona el período especial de inscripción por “matrimonio”?

    FAQs

    Cuando usted se casa, puede calificar para un período especial de inscripción (SEP, por sus siglas en inglés). Usted y su cónyuge pueden inscribirse para obtener cobertura en el mercado de seguros.El período especial de inscripción dura 60 días desde la fecha de la boda. Si usted se inscribe para obtener seguro a través de un SEP, la cobertura comenzará el primer día del mes siguiente.Si vive en un estado que utiliza cuidadodesalud.gov, aplican restricciones.…

  • ¿Cuándo pueden inscribirse los pequeños negocios en cobertura a través del mercado de seguros SHOP?

    FAQs

    Los pequeños empleadores pueden comprar cobertura para sus empleados a través del mercado SHOP en cualquier momento del año. Cuidadodesalud.gov ya no opera un sitio web del Mercado SHOP para pequeños empleadores. Sin embargo, si desea patrocinar la cobertura de un grupo pequeño a través del mercado para sus empleados, puede contactar directamente a las compañías de seguros o trabajar con un corredor certificado para vender pólizas SHOP. En los estados de CuidadoDeSalud.gov, puede encontrar…

  • Soy elegible para recibir beneficios de salud en el trabajo, pero quiero ver si puedo obtener una mejor oferta en el mercado. ¿Puedo hacer eso?

    FAQs

    Siempre puede comprar cobertura en el mercado, asumiendo que cumple con otros requisitos de elegibilidad, pero si tiene acceso a una cobertura a través del trabajo que se determina que es asequible (no más del 9,9% del ingreso del hogar en 2026), es posible que no califique para los subsidios para ayudar a pagar las primas. Puede encontrar más información en esta sección.

  • ¿Qué es el mercado de seguros de salud?

    FAQs

    Los mercados de seguros (también conocidos como de intercambio) son mercados organizados en donde las personas y familias pueden buscar e inscribirse en un seguro médico en línea, por teléfono o en persona. Estos mercados ofrecen una variedad de planes de salud, certifican los planes participantes y brindan información para ayudar a los consumidores a comprender sus opciones y solicitar cobertura. Hay un mercado de seguros en cada estado. Algunos son administrados por el estado…

  • Health Policy Resources for Covering the 2020 Elections

    News Release

    As the 2020 Election Day approaches, many candidates continue to focus on health care issues, including on the public health and economic response to COVID-19, the future of the Affordable Care Act, health care costs and abortion. To help reporters understand and cover these issues, KFF offers independent, non-partisan policy analysis, polling and other research and has experts who can provide context, explain trade-offs and provide key data points on health care issues that may arise…

  • Loss of the Affordable Care Act Would Widen Racial Disparities in Health Coverage

    Policy Watch

    In November, the Supreme Court is scheduled to hear arguments on a legal challenge that seeks to overturn the Affordable Care Act (ACA). This analysis shows that new coverage options under the ACA have contributed to large gains in coverage, particularly among people of color, helping to narrow longstanding racial disparities in health coverage.

  • A Court Ruling Striking Down the ACA Would Eliminate the Medicaid Expansion and Cause Millions of Low-Income People to Become Uninsured

    News Release

    Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November, KFF experts explain in a new Policy Watch post. Overturning the ACA would eliminate the expansion of Medicaid, which largely has been financed by the federal government, and eliminate eligibility for Medicaid for low-income…