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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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  • Key Findings: Kaiser Health Tracking Poll — December 2009

    Poll Finding

    This document contains the key findings from the December Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted December 7 through December 13, 2009, among a nationally representative random sample of 1,204 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (403, including 111 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Assessing Congressional Budget Office Estimates of the Cost and Coverage Implications of Health Reform Proposals

    Issue Brief

    This issue brief explains key elements of the Congressional Budget Office's estimates of the major health reform bills pending in Congress, the Affordable Health Care for America Act (H.R. 3962) and the Patient Protection and Affordable Care Act (H.R. 3590). Throughout the health reform debate, CBO has analyzed these and other bills and provided projections of the costs and savings to the federal government associated with the plans over a 10-year period, as well as…

  • Kaiser Health Tracking Poll — February 2009

    Poll Finding

    The first Kaiser Health Tracking Poll of 2009 finds the public is increasingly worried about the affordability and availability of care, with many postponing or skipping treatments due to cost in the past year and a notable minority forced into serious financial straits due to medical bills. Slightly more than half (53%) of Americans say their household cut back on health care due to cost concerns in the past 12 months. The most common actions…

  • Kaiser Health Tracking Poll: Election 2008 — August 2008

    Poll Finding

    The latest Kaiser Health Tracking Poll: Election 2008 poll finds that one in four (24%) Americans continues to struggle with paying for health care. Health care ranks as a "serious problem" above paying for food (18%), problems with debt (16%), and paying the rent or mortgage (15%) and below paying for gas (37%) or getting a good paying job or raise in pay (26%). Among the 24 percent that find paying for health care or…

  • Americans Are Divided About Health Reform Proposals Overall, But the Public, Including Critics, Becomes More Supportive When Told About Key Provisions

    News Release

    MENLO PARK, Calif. – A new Kaiser Family Foundation poll finds that Americans are divided over congressional health reform proposals, but also that large shares of people, including skeptics, become more supportive after being told about many of the major provisions in the bills. The January Kaiser Health Tracking Poll, conducted before the Massachusetts Senate vote, finds opinion is divided when it comes to the hotly debated legislation, with 42 percent supporting the proposals in…

  • Kaiser Health Tracking Poll: April 2013

    Feature

    With open enrollment in new health coverage options created under the Affordable Care Act set to begin in October, much of the public remains confused about the status of the law. The April 2013 Kaiser Health Tracking Poll provides a rough baseline of public awareness of the ACA before more intensive consumer information and consumer assistance efforts begin.

  • KFF September Tracking Poll Looks at Health Reform and the Elections

    Perspective

    The tug of war for public opinion on health reform continues this month, with approval and disapproval remaining in the same relatively narrow band each has occupied since passage even as favorable views regain a small upper hand, 49 percent favorable vs. 40 percent unfavorable. Opinion is more closely divided among this fall’s likely voters (46 percent vs. 45 percent), and opponents of the law continue to hold their views more emphatically than supporters. Meanwhile,…

  • Dissatisfaction with Health Insurance Despite Positive Ratings

    Perspective

    Personal experiences with the health care system are a key factor in Americans’ opinions on how the health care system should function and their expectations of how the Affordable Care Act (ACA) will change the system when fully implemented. In order to take a closer look at these personal experiences, this post explores findings from the March Kaiser Health Tracking Poll on Americans’ views of their health care and coverage, including health insurance ratings and…

  • June Kaiser Health Tracking Poll: Americans Still Divided on Health Reform Law

    Perspective

    In the latest Kaiser Health Tracking Poll, the public remains divided in their overall assessments of the ACA, with 42 percent holding a favorable view of the law and 46 percent an unfavorable one. This month’s poll finds Americans are somewhat more likely to think their own families, seniors as a group, and the Medicare program will be worse off rather than better off under the law, though large shares say they don’t know or…

  • Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

    Issue Brief

    To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…