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The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • How Could the Build Back Better Act Affect Uninsured Children?

    Issue Brief

    This brief examines characteristics of uninsured children in 2020 and discusses how current policy proposals, including outreach efforts, continuous eligibility requirements, and closing the coverage gap, could affect children’s health coverage. Recent efforts to expand coverage for adults could benefit children’s coverage, especially for children in non-expansion states if the coverage gap is filled as proposed by the Build Back Better Act (BBBA).

  • Before New Ban, the Prevalence of Surprise Bills

    Feature

    Patients with certain conditions appear to be at higher risk for receiving surprise bills. They should be aware of new federal protections against surprise bills and know how to seek out help if they have improperly received one.

  • Marketplace Sign-ups Increased by 21% in 2022

    Feature

    Forty-seven states saw Marketplace enrollment increase, ranging from 1% in Rhode Island to 42% in Texas. In 20 states, enrollment increased by more than 20%.

  • People With HIV in Non-Medicaid Expansion States: Who Could Gain Coverage Eligibility Through Build Back Better or Future Expansion?

    Issue Brief

    In this analysis, we explore the implications of the Build Back Better Act's current coverage provisions for people with HIV in select non-expansion states. We estimate the size of the population that could gain eligibility as well as their socio-demographic characteristics, examine their affordability barriers and assess the potential impact on the Ryan White HIV/AIDS Program. We also explore what Medicaid expansion could mean in these non-expansion states for people with HIV.

  • Standardized Plans in the Health Care Marketplace: Changing Requirements

    Issue Brief

    This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.

  • About 1 in 20 People with Private Insurance Received Services that Could be Affected by a District Court Ruling Limiting the ACA’s Preventive Services Mandate

    News Release

    A new KFF analysis finds about 1 in 20 privately insured people (5.7%) received at least one ACA preventive service or drug that could be affected by a now-stayed U.S. District Court ruling in Braidwood Management v. Becerra, which found the Affordable Care Act’s (ACA) preventive services mandate partially unconstitutional. The district court also found that pre-exposure prophylaxis (PrEP), medication recommended for HIV prevention, violates the religious rights of those who have objections to its…

  • Marketplace Insurers are Proposing a 6% Average Premium Hike for 2024 and Pointing to Inflation as a Key Driver of Costs

    News Release

    ACA Marketplace insurers are requesting a median premium increase of 6% for 2024, according to a new KFF analysis of the preliminary rate filings. Insurers’ proposed rate changes – most of which fall between 2% and 10% – may change during the review process. Although most Marketplace enrollees receive subsidies and are not expected to face these added costs, premium increases could result in higher federal spending on subsidies. Insurers cite price increases for medical…

  • What is a grandfathered plan? How do I know if I have one?

    FAQs

    Grandfathered plans are those that were in existence on March 23, 2010, and have stayed basically the same. Grandfathered plans are not required to provide all of the benefits and consumer protections required by the Affordable Care Act. For example, a grandfathered plan might not cover preventive health services, it might charge higher premiums based on health status or gender, and it might exclude coverage for pre-existing conditions. If you buy coverage on your own and you…