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

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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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  • ¿Cómo funcionan los subsidios para las primas?

    FAQs

    Los subsidios para las primas reducen la prima (lo que paga cada mes por su cobertura) para la mayoría de los planes del mercado de seguros. El monto del crédito fiscal que puede recibir depende de sus ingresos y del costo de los planes de salud del mercado en su área. El mercado determinará la contribución esperada que debe pagar para la prima de un plan de referencia de rango medio (Plata). La contribución esperada…

  • Nine Changes to Watch in ACA Open Enrollment 2023

    Policy Watch

    The 2023 Affordable Care Act (ACA) Open Enrollment period will run from November 1, 2022 to January 15, 2023 in most states, longer in some state-based marketplaces. This policy watch examines nine changes that may affect what enrollees pay for coverage, the size of tax credits for those eligible, and other changes that could affect enrollees' experiences.

  • 2021 Calculator – Before COVID-19 Relief

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2021 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • 2021 Calculadora – Antes COVID-19 Alivio

    Interactive

    Nota: esta calculadora refleja las primas para 2021. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • 2021 Calculadora – Antes COVID-19 Alivio

    Interactive

    Nota: esta calculadora refleja las primas para 2021. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • I’m unemployed, and even with UI benefits, I think my 2021 income will be less than the poverty level ($12,760 for a single person in 2021). Can I qualify for marketplace subsidies?

    FAQs

    Yes.  Generally, people must have an annual income at least as high as the federal poverty level in order to qualify for marketplace subsidies.  In states that have not expanded Medicaid eligibility, that leaves poor adults with no access to financial help for health coverage.  However, during 2021 only, people who receive UI benefits during the year and who live in non-expansion states can receive a premium tax credit and cost-sharing subsidies even if their…

  • I am unemployed and receiving UI this year, but my income is low enough to qualify for Medicaid and I live in an expansion state. Can I choose between that and marketplace subsidies?

    FAQs

    No.  If you are eligible for Medicaid you cannot be eligible for marketplace subsidies.  Some people who receive UI benefits will be eligible for Medicaid, in part because Medicaid will NOT take into account the $300 per week federal supplemental UI benefits.  When you apply through the marketplace, you will receive a determination indicating whether you are eligible for Medicaid.  Medicaid coverage is also free or low cost (some states charge a nominal monthly premium…

  • I lost my job and health benefits. I’d like to continue coverage under my group plan through COBRA but am worried I won’t be able to afford it. Is there any help for me?

    FAQs

    Yes.  The American Rescue Plan provides for new, temporary COBRA premium subsidies for people who lost their jobs or had their hours cut so they no longer qualify for group health benefits.  The law provides for a 100% premium subsidy for COBRA for up to 6 months.  The first subsidy-eligible month is April 2021 and the last subsidy-eligible month is September 2021.  Employers will pay the COBRA premium for subsidy-eligible individuals and be reimbursed by…