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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

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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  • Kaiser Health Tracking Poll: Health Care Priorities for 2017

    Feature

    The most recent Kaiser Health Tracking Poll finds that health care is among the top issues, with the economy and jobs and immigration, Americans want President-elect Donald Trump and the next Congress to address in 2017. As Congressional lawmakers make plans for the future of the Affordable Care Act, the latest survey finds the public is divided on what they would like lawmakers to do when it comes to the 2010 health care law with…

  • Obamacare Debate: Where GOP Governors Stand on Repeal and Replace

    From Drew Altman

    As congress prepares to vote on repeal of the Affordable Care Act, Drew Altman discusses whether Republican governors and congressional Republicans will be at odds over key issues when it comes to repealing and replacing the law in this Wall Street Journal Think Tank column.

  • Major Considerations for Repealing and Replacing the ACA

    Event Date:
    Event

    The Kaiser Family Foundation and the Committee for a Responsible Federal Budget host a public forum to discuss the process and implications of repealing and replacing the Affordable Care Act, including the implications of using the budget reconciliation process to repeal the ACA, and what an ACA replacement could mean for health insurance coverage and costs.

  • Community Health Centers: Recent Growth and the Role of the ACA

    Issue Brief

    This brief draws on federal data and our 2016 survey of health centers to provide a 2015 profile of health centers, analyze recent changes in patient coverage and service capacity, and compare health centers in Medicaid expansion and non-expansion states. It also considers the implications of a repeal of the ACA for health centers and the low-income communities they serve.

  • The ACA Ruling Shows How the Times Have Changed on Health Care

    From Drew Altman

    In this Axios column about the Texas court decision, Drew Altman shows that many provisions of the Affordable Care Act are even more popular than protections for pre-existing conditions, the issue which put Republicans on the defensive and helped Democrats in the midterm elections.

  • If the Affordable Care Act is Struck Down, Nearly All Americans Would Be Affected in Some Way

    News Release

    The Affordable Care Act’s changes to the nation’s health care system are so widespread that nearly all Americans would be affected in some way if a federal judge’s decision ruling the entire law unconstitutional is upheld, according to a new analysis from KFF (the Kaiser Family Foundation). While the changes to the individual insurance market – including protections for people with pre-existing conditions, creation of insurance marketplaces, and premium subsidies for low and modest income…