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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • Health Center Patient Trends, Enrollment Activities, and Service Capacity: Recent Experience in Medicaid Expansion and Non-Expansion States

    Issue Brief

    In thousands of medically underserved communities across the U.S., community health centers enroll low-income people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and…

  • Data Note: Are Nonprofits Requesting an Accommodation for Contraceptive Coverage?

    Issue Brief

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services, including most contraceptives for women. This policy was at the center of a Supreme Court case brought forward by for-profit corporations (Hobby Lobby and Conestoga) that successfully claimed that the contraceptive coverage requirement violated their religious rights. Last month, the Supreme Court agreed to hear yet another challenge (Zubik v Burwell) to the contraceptive…

  • What’s the Political Power of Those Newly Insured Under Obamacare?

    News Release

      With 17 million people newly-insured since 2014, Drew Altman's latest column for The Wall Street Journal's Think Tank takes a look at whether they will make an impact in the first presidential election since Affordable Care Act enrollment began. All previous columns by Drew Altman are online.

  • Survey of Kentucky Residents on State Health Policy

    Poll Finding

    This survey of Kentucky residents gauges their views on health care policy in the state, including their preferences for the future of the Medicaid expansion and the state-based health insurance marketplace, Kynect. Kentucky has received national attention as the only Southern state to fully embrace the Affordable Care Act, though the state elected a new governor in November 2015 who campaigned on rolling back the Medicaid expansion and ending Kynect.

  • Bernie Sanders, Hillary Clinton, and Medicare for All

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explores the differing positions of presidential candidates Hillary Clinton and Bernie Sanders on a single payer or Medicare-for-all health care system and whether Democratic voters consider it an important factor in the 2016 primaries.

  • Medicaid Expansion Spending and Enrollment in Context: An Early Look at CMS Claims Data for 2014

    Issue Brief

    This issue brief analyzes spending and enrollment data made available by CMS through the MBES. It breaks out spending and enrollment for the new adult group (Group VIII) that gained coverage in states that adopted the ACA Medicaid expansion. It looks at spending and enrollment for the new adult group in calendar year 2014, putting such data in the context of overall Medicaid spending and enrollment and examines trends across expansion states.

  • Health Insurance Marketplace Calculator Updated for 2016

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator is now updated to include local data on 2016 health plans that are being sold through the Affordable Care Act marketplaces. The Spanish-language version of the calculator is also updated.