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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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  • I heard that plans have to cover preventive services without cost sharing. Does this include every preventive service and are there any limitations or exceptions?

    FAQs

    Most health plans, including Marketplace plans, are required to cover a wide range of preventive services and may not impose cost-sharing (such as deductibles, copayments, or co-insurance). The ACA requires private plans to cover services under four broad categories: Evidence-based screenings and counseling Routine immunizations Childhood preventive services Preventive services for women So long as the preventive service is performed by an in-network provider, is not billed separately from the office visit, and is the main…

  • What are premium tax credits and how do they work?

    FAQs

    Premium tax credits reduce your premium for most Marketplace plans. The amount of the tax credit you may receive depends on your income and the cost of Marketplace health plans in your area. The Marketplace will determine the expected contribution you are required to pay toward the premium for a mid-range (Silver) benchmark plan. The expected contribution will increase on a sliding scale based on your 2026 income, with more financial assistance for enrollees with…

  • Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?

    FAQs

    Yes. Many insurers that offer plans through the ACA Marketplace also offer identical plans outside of the Marketplace that meet all ACA standards, although premium tax credits and cost-sharing subsidies are not available for plans sold outside of the Marketplace. Some people prefer to buy health insurance outside of the Marketplace when they are sure they won’t qualify for financial assistance. Like health insurance plans sold on the Marketplace, “ACA-compliant” plans sold outside of the…

  • ¿Qué es el formulario 8962?

    FAQs

    Si recibió un subsidio anticipado para pagar las primas (APTC) a través del mercado el año pasado, debe presentar un formulario 8962 con su declaración de impuestos federal para conciliar sus ingresos estimados y reales del año, incluso si calculó sus ingresos con precisión. Puede obtener un formulario 8962 en blanco en el sitio web del IRS o, si utiliza un software de preparación de impuestos, el formulario se generará automáticamente. Las instrucciones del formulario…

  • ¿Mi empleador debe ofrecerme seguro de salud?

    FAQs

    Si es un trabajador a tiempo completo y trabaja para un gran empleador, su empleador enfrentará una multa si no proporciona cobertura. Algunos empleadores pueden optar por pagar la multa y no ofrecer cobertura. Consulte con su empleador para ver lo que ofrecen.

  • Estoy embarazada y quiero inscribirme en el mercado de seguros. ¿Cómo puedo calcular el tamaño de mi hogar para el próximo año e inscribir a mi bebé?

    FAQs

    Durante la inscripción abierta, aplicará como un hogar de un solo miembro (o de dos si se inscribe con su cónyuge). Cuando nazca el bebé, podrá actualizar la información de su familia en el mercado de seguros para que refleje que se ha convertido en una familia de dos (o de tres si se inscribe con su cónyuge). Después del nacimiento, tendrá un período de inscripción especial de 60 días para agregarlo a su plan.…

  • Escuché que los planes de salud tienen que cubrir servicios sin costos compartidos. ¿Esto incluye a todos los servicios preventivos? ¿Hay límites o excepciones a lo que cubren?

    FAQs

    La mayoría de los planes de salud, incluidos los del mercado de seguros, deben cubrir una amplia gama de servicios preventivos y no pueden imponer costos compartidos (como deducibles, copagos o coaseguros). La Ley de Cuidado de Salud a Bajo Precio (ACA) exige que los planes privados cubran servicios en cuatro categorías generales: Exámenes y asesoramiento basados ​​en la evidencia Vacunas de rutina Servicios preventivos infantiles Servicios preventivos para mujeres Siempre que el servicio preventivo…

  • ¿Qué es el mercado de seguros de salud?

    FAQs

    Los mercados de seguros (también conocidos como de intercambio) son mercados organizados en donde las personas y familias pueden buscar e inscribirse en un seguro médico en línea, por teléfono o en persona. Estos mercados ofrecen una variedad de planes de salud, certifican los planes participantes y brindan información para ayudar a los consumidores a comprender sus opciones y solicitar cobertura. Hay un mercado de seguros en cada estado. Algunos son administrados por el estado…