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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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  • Florida Medicaid Reform Waiver: Early Findings and Current Status

    Issue Brief

    Florida Medicaid Reform Waiver: Early Findings and Current Status This policy brief provides an overview of the Florida Medicaid reform and a summary of available research findings to date from various evaluators of the program. It was issued at the same time as a separate Health Affairs article highlighting findings from Kaiser Family Foundation's 2006-2007 Survey of Florida Medicaid Beneficiaries. The Foundation, in collaboration with the Urban Institute and the University of Florida, is conducting…

  • The Decline in the Uninsured in 2007: Why Did It Happen and Can It Last?

    Issue Brief

    This policy brief examines the underlying shifts in health insurance coverage in 2007, which resulted in a 1.5 million decrease in the number of uninsured people under age 65, due to increased public coverage. This includes about 300,000 in Massachusetts, which implemented its comprehensive health reform that year. The brief also projects that the current economic downturn and rising unemployment rate likely will cause the number of uninsured to grow by at least 2 million…

  • Kaiser Health Tracking Poll: Election 2008 — September 2008

    Poll Finding

    The latest Kaiser Health Tracking Poll: Election 2008 finds that health care has crept up in importance as an election issue in recent months among a key voting group: political independents, who ranked it as highly as Democrats did in this poll.  Roughly one in four (26%) independents rank health care as one of the top issues they would "most like to hear the presidential candidates talk about." Health care's importance has risen among independents by…

  • 2008 Presidential Candidates: Health Care Issues Side-by-Side

    Other Post

    Health care has been an important issue in the 2008 presidential campaign and the candidates have staked out positions on key health care issues. Both major party candidates have developed comprehensive health care reform proposals addressing health coverage and access, rising health care costs and health care quality. The side-by-side comparison available here focuses on important health care issues not necessarily addressed in the candidates' health care reform proposals. It was prepared by the Kaiser…

  • Pulling It Together: What Do We Want Health Insurance To Be?

    Perspective

    Trends in the health insurance marketplace show substantial growth in high deductible health plans, especially among smaller firms, where 35% of workers are now covered by plans with a deductible of $1,000 or more. That's according to our recently released employer health benefits survey, which we have been conducting now for ten years. The majority of these plans are simply high deductible health plans; only a minority are so-called "consumer driven" plans with savings accounts.…

  • Covering the Uninsured: Options for Reform

    Issue Brief

    Download PDF Key Facts on the Uninsured In 2007, 45 million nonelderly people in the United States lacked health coverage More than eight in ten uninsured people (81%) come from working families About two-thirds of the nonelderly uninsured are from low-income families (income below 200% of poverty, about $42,400 for a family of 4 in 2007) More than one in three people (35%) living in poverty are uninsured, compared with one in twenty people (5%)…

  • Kaiser Health Tracking Poll: Election 2008 — August 2008

    Poll Finding

    The latest Kaiser Health Tracking Poll: Election 2008 poll finds that one in four (24%) Americans continues to struggle with paying for health care. Health care ranks as a "serious problem" above paying for food (18%), problems with debt (16%), and paying the rent or mortgage (15%) and below paying for gas (37%) or getting a good paying job or raise in pay (26%). Among the 24 percent that find paying for health care or…

  • New Study Examines the Current Spending on Health Care for the Uninsured and Projects the Cost of Additional Medical Care if the Population Were Insured

    Report

    This study examines the current spending on care for the uninsured and projects additional medical spending if the population had health insurance coverage. The study finds that the uninsured will spend $30 billion out-of-pocket for health care in 2008 while receiving $56 billion in uncompensated care, three quarters of which will be from government sources. The study is an update of a previous Kaiser study and also projects the additional cost to the nation’s health…

  • Health Care and the Economy in Two Swing States: A Look at Ohio and Florida

    Poll Finding

    Two new surveys by NPR, the Kaiser Family Foundation and the Harvard School of Public Health examine the pocketbook problems facing people in Ohio and Florida -- two presidential swing states -- including their struggles with gas prices, getting and keeing a well-paying job and affording health care. The surveys, , also take an in-depth look at the impact of medical bills on family finances and health care, and provide insights into the way health…