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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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  • ¿Qué pasa si invento un salario más alto con el cual sé que calificaré para recibir ayuda financiera?

    FAQs

    Eso no es aconsejable. El mercado verificará la información que usted proporciona con una serie de bases de datos (incluidos datos del IRS, datos del Seguro Social, bases de datos salariales y otras). Si la información que proporciona es muy diferente de la que se encuentra en estas bases de datos, es posible que se le solicite que proporcione documentación adicional. Además, al final de la solicitud de cobertura de salud y ayuda para pagar…

  • ¿Qué es el mercado de seguros de salud?

    FAQs

    Los mercados de seguros (también conocidos como de intercambio) son mercados organizados en donde las personas y familias pueden buscar e inscribirse en un seguro médico en línea, por teléfono o en persona. Estos mercados ofrecen una variedad de planes de salud, certifican los planes participantes y brindan información para ayudar a los consumidores a comprender sus opciones y solicitar cobertura. Hay un mercado de seguros en cada estado. Algunos son administrados por el estado…

  • Me enteré que mi cobertura de Medicaid terminó. ¿Qué hago ahora?

    FAQs

    Si pierde Medicaid pero cree que aún califica, comuníquese con su agencia de Medicaid. Si su cobertura terminó hace menos de 90 días, es posible que pueda enviar los formularios y documentos requeridos y restablecer su cobertura. En este caso, su cobertura será retroactiva a su fecha de baja. Si su cobertura terminó hace más de 90 días, es probable que deba volver a aplicar para Medicaid. Si la agencia de Medicaid dice que usted…

  • My company provides funds for workers to buy health insurance on their own instead of providing health insurance through the company. Can I still qualify for premium tax credits to buy a Marketplace plan?

    FAQs

    Employees who receive funds to buy health insurance on the individual market can sometimes still qualify for premium tax credits, depending on the type of health reimbursement arrangement (HRA) their employer offers and its affordability to you: Employers with fewer than 50 workers may offer what’s known as a Qualified Small Employer HRA. If your employer offers this type of coverage arrangement and it is considered “affordable” based on your household income, you will not…

  • ¿Qué es un plan de salud para estudiantes?

    FAQs

    Un plan de salud estudiantil es un tipo especial de cobertura médica que las universidades ofrecen a sus estudiantes matriculados. Normalmente, un plan de salud estudiantil es diferente de la cobertura patrocinada por el empleador que las universidades ofrecen a su plantel de profesores y a su personal.

  • ¿Qué tipos de planes médicos venden los sitios web de inscripción privada?

    FAQs

    Los sitios web de inscripción privada administrados por compañías de seguros generalmente solo muestran los planes que ofrece esa aseguradora. Los sitios web administrados por corredores de seguros deben mostrar todos los planes ofrecidos por varias aseguradoras. Si tiene preguntas o inquietudes sobre la información en estos sitios, comuníquese con el centro de atención telefónica del mercado, con cuidadodesalud.gov o con el mercado de su estado. Muchos sitios web de inscripción privada también venden planes…

  • Does being lesbian, gay, bisexual, or transgender (LGBT) affect my health insurance coverage and options? What if I am married to my same-sex partner?

    FAQs

    You cannot be turned away or charged more for being lesbian, gay, bisexual, or transgender. You also can’t be denied coverage or charged more because of any pre-existing health condition, such as HIV status. Insurers can’t have any annual or lifetime limits on how much they’ll spend on your medical care. Additionally, health programs that receive federal funding, such as Marketplace plans, Medicaid, and Medicare, cannot discriminate based on sex. Notably, though, the legal landscape is evolving.…

  • Do Marketplace plans or Medicaid cover abortions?

    FAQs

    It depends on where you live and what type of coverage you have. For Marketplace plans, there is no federal requirement for plans to cover abortion. About half of states prohibit Marketplace plans from covering abortion. However, other states require plans to cover abortion services and do not permit cost sharing. For Medicaid enrollees, federal law only allows the use of federal funds for abortion in cases of rape, incest, or life endangerment of the pregnant…

  • When can I apply for Marketplace premium tax credits when other coverage is available?

    FAQs

    In general, if you have or are offered other comprehensive, affordable coverage, you may not be eligible for premium tax credits on the Marketplace. However, there are several circumstances where you may be eligible. This chart lays out examples of different coverage types and whether or not they will disqualify you for premium tax credits.