Home Affordable Care Act Topics

Affordable Care Act

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?

Latest News

More KFF Health News

Stay informed.

Get KFF's latest on the Affordable Care Act

Stay informed.

Get KFF's
latest on the Affordable
Care Act

View the Latest: Affordable Care Act

Filter

List Grid

2,591 - 2,600 of 2,787 Results

  • An Estimated 1.5 Million People with Pre-Existing Conditions Could Face Higher Premiums Under Cruz Amendment

    News Release

    A new analysis from the Kaiser Family Foundation estimates that 1.5 million people with pre-existing conditions could face higher premiums under an amendment suggested by Sen. Ted Cruz to the Better Care Reconciliation Act (BCRA), the Senate’s proposed replacement for the Affordable Care Act (ACA). The amendment, which is being discussed but has not been introduced, reportedly would allow insurers in the non-group market to sell some policies that don’t follow all ACA market rules…

  • Growing Majority of Americans Oppose Congress’ Plan to Repeal and Replace the Affordable Care Act

    News Release

    Intensity Gap: Democrats are Twice as Enthusiastic about the ACA than Republicans are About Its Replacement Two-Thirds of Public Oppose Major Medicaid Cuts as Part of Repeal and Replace Plan As the U.S. Senate continues to debate their plan to repeal and replace the 2010 Affordable Care Act, the latest Kaiser Family Foundation tracking poll finds the public souring on the effort with a growing majority opposed to the plan. This month’s poll finds 61…

  • Senate Health Bill Proposes Big Changes to Medicaid Beyond Repealing and Replacing the ACA

    News Release

    The Better Care Reconciliation Act (BCRA) under consideration in Congress includes provisions that would fundamentally change Medicaid by phasing out extra federal funding for states’ Medicaid expansions and for the first time limiting federal spending on Medicaid through a per enrollee cap on financing or a block grant for certain adults. While those measures account for most of the bill’s $756 billion reduction in federal Medicaid spending over the next decade, there are other big…

  • The ACA Stability “Crisis” In Perspective

    From Drew Altman

    In this column for Axios, Drew Altman presents new data analysis showing how many people are impacted by premium increases in the non-group market, and discusses the implications. 

  • Early Analysis of 21 Major Cities Tracks ACA Marketplace Premium Changes, Insurer Participation, Uncertainty

    News Release

    As insurers grapple with continuing uncertainty surrounding 2018 Affordable Care Act (ACA) marketplaces, a new Kaiser Family Foundation analysis of initial filings in 21 major cities finds that changes in 2018 benchmark silver plan premiums are likely to range widely, from a decrease of 5 percent in Providence, R.I., to an increase of 49 percent in Wilmington, Del., without factoring in tax credits. However, the analysis finds that preliminary rates will likely change, and some…

  • Medicaid: What We Learned From the Recent Debate and What to Watch for in September 2017

    Issue Brief

    The inclusion of major Medicaid changes in both the American Health Care Act (AHCA) that passed in the House and the Better Care Reconciliation Act (BCRA) considered in the Senate revealed that is hard to gain consensus on significant cuts and reforms to Medicaid. Medicaid has broad general support and intense support from special populations served by the program. In addition, proposed changes would have different implications across states due to significant program variation across…

  • How to Keep ACA Stabilization Narrow

    From Drew Altman

    In this column for Axios, Drew Altman discusses the main challenges for members and media coverage as members take up the issue of stabilization of the Affordable Care Act.

  • State-by-State Estimates of Changes in Federal Spending on Health Care Under the Graham-Cassidy Bill

    Issue Brief

    A new health care bill recently introduced by a number of senators led by Senators Lindsey Graham and Bill Cassidy would repeal major elements of the Affordable Care Act (ACA), make changes to other ACA provisions, and fundamentally alter federal Medicaid financing. In this brief, we estimate changes in federal funding due to the new block grant program and the Medicaid per enrollee cap on a state-by-state basis under the Graham-Cassidy bill relative to current…

  • 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…