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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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  • Updated Subsidy Calculator and 300+ FAQs Help Consumers Understand the ACA Marketplaces as Open Enrollment Begins

    News Release

    Ahead of the annual Affordable Care Act (ACA) open enrollment period, the time during which consumers can shop for health plans or renew existing coverage, KFF has updated its Health Insurance Marketplace Calculator and its searchable collection of more than 300 Frequently Asked Questions about open enrollment, the health insurance marketplaces and the ACA. KFF’s Health Insurance Marketplace Calculator provides estimates of 2021 health insurance premiums and subsidies for people purchasing insurance on their own in health…

  • Calculadora del Mercado de Seguros Médicos

    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…

  • Web Briefing: The California v. Texas Supreme Court Case and Its Implications for the ACA

    Event Date:
    Event

    On Tuesday, Nov. 10, the Supreme Court will hear oral arguments on a legal challenge supported by the Trump administration that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. KFF held an interactive web briefing on Monday, Nov. 9, to share insights about the legal issues in the case and the potential…

  • Strategies To Lower Drug Costs Top the Public’s Health Priorities for Congress

    News Release

    Against the backdrop of public concern about inflation and rising gas prices, proposals to lower what people pay out-of-pocket for drugs tops the public’s list of health care priorities for Congress, a new KFF Health Tracking Poll finds. Most (55%) of the public say inflation is the biggest problem facing the country. Fewer cite other issues such as the Russian invasion of Ukraine (18%), climate change (6%), the COVID-19 pandemic (6%), and crime (6%). The…

  • How Has the Pandemic Affected Health Coverage in the U.S.?

    Policy Watch

    Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces.