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?

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  • Analysis of UnitedHealth Group’s Premiums and Participation in ACA Marketplaces

    Issue Brief

    This analysis looks at how a potential withdrawal by UnitedHealth Group from the Affordable Care Act (ACA) marketplaces in 2017 could impact insurer competition and premiums, finding a significant impact in some markets, though it would have a minimal effect on the average benchmark premium nationwide, The impacts of a UnitedHealth withdrawal would vary considerably by state and market area, with a more pronounced effect in rural areas. Since UnitedHealth often is not one of…

  • Insurer Competition, Monthly Premiums Could Be Affected in Some Markets if UnitedHealth Group Exits ACA Marketplaces

    News Release

    A withdrawal by UnitedHealth Group from the Affordable Care Act (ACA) marketplaces in 2017 could have a significant impact on insurer competition and premiums in some markets, though it would have a minimal effect on the average benchmark premium nationwide, according to a new analysis from the Kaiser Family Foundation. Late last year, UnitedHealth announced that it experienced significant financial losses in ACA compliant plans and that it would decide about future participation in ACA…

  • Kaiser Health Tracking Poll: April 2016

    Report

    The April Kaiser Health Tracking Poll examines the role of health care issues in the presidential election. Health care is one of the top four issues mentioned by voters when asked which issues they most want to hear candidates discuss in the campaign, but half as many cite health care as mention the economy and jobs. It also examines the public’s experiences with prescription painkiller abuse and access to mental health care, as well as…

  • The ACA and People with HIV: An Update

    Issue Brief

    This report provides a second look at how the Affordable Care Act (ACA) is impacting people with HIV two years into these new coverage opportunities, based on focus groups conducted with HIV positive individuals from five states in early 2016, after the third round of open enrollment. Groups were conducted with HIV positive individuals who gained insurance coverage – through either the Marketplaces or Medicaid expansion- in California and New York and with those who…

  • Most Americans Say Federal and State Governments Are Not Doing Enough to Combat Prescription Painkiller and Heroin Abuse; Large Majorities Believe Wide Range of Strategies Would be Effective

    News Release

     As the White House and Congress continue to debate new funding and other actions to address the nation’s opioid epidemic, the latest Kaiser Health Tracking Poll finds that most Americans believe the federal government is not doing enough to combat the recent increases in the number of people who are addicted to prescription painkillers (66%) or heroin (62%). State governments fare no better in the public’s view, with similarly large shares saying they aren’t doing…

  • What to Look for in 2017 ACA Marketplace Premium Changes

    Perspective

    This brief discusses the key factors that will influence the rate changes that insurers are requesting in 2017 Affordable Care Act (ACA) Marketplaces, including current premiums, forecasted enrollment changes, increases in price and use of services, changes in policy design or network, changes in law or regulation, and competition.

  • Partisanship’s Grip On The Affordable Care Act

    From Drew Altman

    In this Wall Street Journal's Think Tank column Drew Altman analyzes data from an upcoming Kaiser poll and discusses how partisanship is the dominant factor shaping views of the Affordable Care Act for Republicans and Democrats enrolled in marketplace plans.

  • Puerto Rico: Fast Facts

    Fact Sheet

    Puerto Rico: Fast Facts provides a quick snapshot of the island's demographic, health, and economic characteristics. It also provides some information on federal Medicaid rules, infrastructure, and fiscal challenges ahead.