Affordable Care Act

The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • KFF Health Tracking Poll – July 2019: The Future of the ACA and Possible Changes to the Current System, Preview of Priorities Heading Into 2nd Democratic Debate

    Feature

    This month's KFF Health Tracking Poll explores public opinion towards a government-administered public option, and finds that attitudes can change after hearing common arguments. The poll also examines the public's views toward Medicare-for-all and the Affordable Care Act, as well as the top issues for Democrats ahead of the second round of presidential debates.

  • Benchmark Employer Survey Finds Average Family Premiums Now Top $20,000

    News Release

    Annual family premiums for employer-sponsored health insurance rose 5% to average $20,576 this year, according to the 2019 benchmark KFF Employer Health Benefits Survey released today. Workers’ wages rose 3.4% and inflation rose 2% over the same period. On average, workers this year are contributing $6,015 toward the cost of family coverage, with employers paying the rest.

  • State Marketplace Profiles: Delaware

    Other Post

    Final update made on October 10, 2013 (no further updates will be made) Establishing the Marketplace In July 2012, Governor Jack Markell (D) indicated that Delaware would begin planning for a State Partnership Marketplace.1  Delaware will retain plan management and consumer assistance functions, and defer other Marketplace management functionality to the federal government.2  In July 2013, the state announced that the Marketplace would be called Choose Health Delaware. The Delaware Health Care Commission, housed within the Department…

  • State Exchange Profiles: Mississippi

    Other Post

    Final update made on February 11, 2013 (no further updates will be made) Establishing the Exchange In October 2011, Mississippi’s elected Commissioner of Insurance Mike Chaney (R) announced that the state would establish a Health Insurance Exchange that would be operated by the Mississippi Comprehensive Health Insurance Risk Pool Association and regulated by the Insurance Department.1 However, Governor Phil Bryant (R) has opposed the effort to establish a state-based exchange. The Comprehensive Health insurance Risk Pool…

  • State Marketplace Profiles: New Hampshire

    Other Post

    Final update made on November 1, 2013 (no further updates will be made) Establishing the Marketplace On June 18, 2012, Governor John Lynch (D) signed HB 1297 into law, which prohibits the state from participating in or enabling a state-based health insurance Marketplace. However, HB 1297 allows for state agencies or departments to “operate specific functions of a federally-facilitated exchange."1  Given this authority, newly-elected Governor Maggie Hassan (D) informed federal officials on February 13, 2013 that…

  • State Exchange Profiles: Montana

    Other Post

    Final update made on April 19, 2013 (no further updates will be made) Establishing the Exchange In December 2012, Montana’s elected State Auditor Monica Lindeen (D) confirmed that the federal government would operate a health insurance exchange in Montana.1 The previous year, two proposed bills (HB620 and HB124) to establish a health insurance exchange in Montana failed.2,3 Instead, the legislature passed SB 228, a bill that would prohibit the creation of a health insurance exchange as proscribed…

  • State Marketplace Profiles: District of Columbia

    Other Post

    Final update made on October 1, 2013 (no further updates will be made) Establishing the Marketplace On December 20, 2011 the District of Columbia City Council gave final approval to a bill establishing the District of Columbia Health Benefit Exchange Authority (HBX) and in late January 2012, Mayor Vincent Gray (D) signed the legislation into law (Act 19-269).1  The bill was also subject to a 30-day Congressional review. In June 2013, the District of Columbia announced that its new…