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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

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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  • Health Reform Quiz

    Feature

    Take our short, 10-question quiz to test your knowledge of the law, and then share your results with friends on Twitter or Facebook.

  • Health Coverage for the Hispanic Population Today and Under the Affordable Care Act

    Report

    The more than 50 million Hispanics living in the United States make up 17 percent of the total population and are the nation's fastest growing racial or ethnic group. Many Hispanics continue to face disparities in health coverage and care, and they have the highest uninsured rate among racial/ethnic groups, with nearly one in three lacking coverage. This brief provides an overview of the Hispanic population in the U.S., their health coverage today and the…

  • Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

    Issue Brief

    This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

  • Webinar for Journalists: Women’s Health Under the Affordable Care Act

    Event Date:
    Event

    The Kaiser Family Foundation hosted an interactive webinar for journalists through its Media Fellowships Program: "Women's Health Under the Affordable Care Act," which took place on Thursday, February 6 from 12:30 p.m. to 1:30 p.m. ET. Now that the ACA's coverage expansions are in effect, the Foundation's latest webinar looked at how the law affects women's access to health coverage and care. The Kaiser Family Foundation's Alina Salganicoff, Vice President and Director of Women's Health Policy, and…

  • Annual Change in Medicaid Enrollment in 50 States and DC, June 2000 to June 2011

    Medicaid Enrollment: June 2013 Data Snapshot

    Issue Brief

    This Data Snapshot provides 50-state data on Medicaid monthly enrollment trends, adding June 2013 data. Overall, Medicaid enrollment growth continued to slow to the lowest rate since the start of the Great Recession as the economic conditions continued to slowly improve. While enrollment growth rates have been trending downward as economic conditions continue to slowly improve, enrollment growth is expected to increase significantly as states implement the ACA. Regardless of whether states decide to implement…

  • Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

    Issue Brief

    This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the…

  • County-Level Analysis Finds ACA Premiums are Falling in Many Areas of the Country, Though Changes Vary by County and Type of Plan

    News Release

    Premiums for the Affordable Care Act Marketplace benchmark silver plan are decreasing 3.1 percent on average across the country – the fourth year in a row that benchmark premiums have fallen – though the changes vary by county, a new KFF county-by-county analysis finds. The benchmark plan premiums are important because they are used to determine the tax credits available to people who buy their own insurance through the Marketplaces. What people would have to…