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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  • Me gusta mi plan de mercado tal como es. ¿Se mantendrá igual el año que viene?

    FAQs

    Depende. Las aseguradoras pueden hacer cambios a los planes cada año. Lo más probable es que la prima de su póliza actual cambie el próximo año. También puede haber otros cambios como en los deducibles o copagos para algunos servicios. En algunos casos, una aseguradora puede dejar de ofrecer un plan particular y ofrecerle nuevas opciones, en su lugar. Poco antes de que comience la inscripción abierta, debe recibir un aviso de su compañía de…

  • ¿Qué pasa si termino necesitando atención de un doctor que está fuera de la red de mi plan?

    FAQs

    Los planes no están obligados a cubrir la atención recibida de un proveedor que no pertenece a la red, aunque algunos planes del mercado lo hacen, al menos en cierta medida. Si recibe atención fuera de la red, podría ser costoso para usted. En general, los planes que brindan una opción fuera de la red cubren dicha atención a una tasa más baja (por ejemplo, se puede reembolsar el 80% de los costos dentro de…

  • Compré anticonceptivos de emergencia de venta libre en mi farmacia y pensé que mi seguro los cubriría, pero terminé teniendo que pagar el costo total de mi bolsillo. ¿Por qué no lo cubre mi seguro?

    FAQs

    La anticoncepción de emergencia es uno de los métodos aprobados por la Administración de Drogas y Alimentos (FDA) para mujeres que debe estar cubierto por la mayoría de los planes de salud, incluidos los que se venden en el mercado de seguros. Sin embargo, debe ser recetada por un profesional de salud para que la mayoría de los planes la cubran. Si no tiene una receta, probablemente tendrá que pagar el costo total de su…

  • Can immigrants get help paying premiums and/or cost-sharing for health insurance in the Marketplaces?

    FAQs

    Most lawfully present immigrants can usually get tax credits to help pay premiums and cost-sharing for health insurance through the Marketplaces. Like citizens, they can get premium tax credits that vary on a sliding scale, based on income. Generally, people must have income at least as high as 100% of the federal poverty level ($15,650 for a single adult or $32,150 for a family of four) in 2026 to qualify for premium tax credits. People…

  • I entered estimated income information for next year on my Marketplace application. I expect my income next year will be much lower than it was this year because I had to change jobs. HealthCare.gov say...

    FAQs

    A data match issue means the Marketplace is not able to verify the information on your application based on the data it has available to them. Usually, when this happens, HealthCare.gov will temporarily determine that you are eligible for tax credits, based on the income that you attested you expect to earn next year, but it will require you to send additional documentation. People are typically given up to 90 days to submit documentation. If…

  • Compramos seguro en el mercado en nuestro estado, pero nuestro hijo va a la universidad en otro. Queremos tenerlo en nuestro plan. ¿Podemos hacerlo?

    FAQs

    Sí. Su hijo puede inscribirse en su plan familiar del Mercado, incluso si vive fuera del estado. Sin embargo, es posible que su hijo deba regresar a casa para acceder a la atención dentro de la red de su plan. Si reciben servicios de atención médica en otro estado, los proveedores de salud pueden estar fuera de la red de su plan, y es posible que usted tenga que pagar copagos o coseguros de costos…

  • I have been trying to get pregnant. Do Marketplace plans cover infertility services?

    FAQs

    The ACA does not require health plans to cover infertility services; however, some states require certain plans to cover certain infertility services. If you need these services and are shopping for coverage, check the plan details or your state insurance department about coverage and out-of-pocket costs for infertility care.

  • Who can buy a Catastrophic Plan?

    FAQs

    In general, Catastrophic plans may only be sold to young adults under the age of 30. However, there are certain financial hardship and affordability exemptions for people ages 30 and older, including if there is no qualified health plan offered on or off the Marketplace that would cost less than 8.05% of their income in 2026, or if they are not eligible for premium tax credits or cost-sharing reductions based on their projected annual income.…

  • What is a Catastrophic health plan?

    FAQs

    A “Catastrophic plan” is a qualified health plan offered on or off the Marketplace that covers the “essential health benefits.” While Catastrophic plans have lower premiums than other qualified health plans, they also have the highest level of cost sharing allowable for an ACA-compliant plan. For 2026, the annual deductible for covered services in a Catastrophic plan is $10,600 for an individual or $21,200 for a family. The plan does not have to cover more…

  • I’m a young adult and I need health insurance. What are my coverage options?

    FAQs

    A number of options may be available to you: If your annual income is $21,597 or less in 2026 (138% federal poverty level for a single adult), you may qualify for Medicaid coverage. Not all states have elected to expand Medicaid eligibility to this income level. Check with a navigator or another type of assister using Find Local Help, or check with your state Marketplace to learn more about Medicaid eligibility in your state.  If…