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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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  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…

  • What Women Think of the Core Issue in the Hobby Lobby Case

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case. Overall, by a margin of…

  • Why the Political Heat on the ACA Is Cooling

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores some early indicators that the political waters may be calming for the Affordable Care Act.

  • National Survey Finds 10.6 Million People Helped By Navigators and Assisters During the Affordable Care Act’s First Open Enrollment Period

    News Release

    An estimated 10.6 million people nationally received personal help from navigators and assisters during the Affordable Care Act's first open enrollment period, finds a new Kaiser Family Foundation survey of navigators and assister programs nationally. The survey estimates that the 4,400 assister programs operating nationally had an estimated 28,000 full-time staff and volunteers, suggesting each assister would have helped more than 370 people on average during the six-month open enrollment period that ran from October…

  • What’s Trending in Health Care? Conservative Ideas

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

  • Where are California’s Uninsured Now? Wave 2 of the Kaiser Family Foundation California Longitudinal Panel Survey

    Report

    This second wave of the Kaiser Family Foundation's California uninsured survey assesses the impact of the Affordable Care Act to date on state residents who were uninsured prior to open enrollment. The results capture the share of previously uninsured Californians who gained coverage or remained uninsured, how they feel about and interact with their new coverage options and what barriers to getting insurance remain. The report examines breakouts by race, coverage type, and other demographic…

  • Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act.

  • The Potential Side Effects of Halbig

    Perspective

    The Halbig case, if it prevails, would have far-reaching side effects on the Affordable Care Act’s employer mandate and the functioning of the individual insurance market.

  • Drew Altman: Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act. All previous columns by Drew Altman are available online.