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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.

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

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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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  • Holding Steady, Looking Ahead: Annual Findings Of A 50-State Survey Of Eligibility Rules, Enrollment and Renewal Procedures, And Cost Sharing Practices in Medicaid and CHIP, 2010-2011

    Report

    The annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost sharing practices, conducted by the Kaiser Commission on Medicaid and the Uninsured with the Georgetown University Center for Children and Families, found that, in 2010, coverage in Medicaid and the Children's Health Insurance Program remained strong with some improvements, particularly for low-income children. However, eligibility for their parents and other low-income adults continued to lag behind. The survey also…

  • Key Findings: Kaiser Health Tracking Poll — August 2009

    Poll Finding

    This document contains the key findings from the August Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted August 4 through August 11, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 123 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Community Health Centers: Can They Plug the Gaps in the Safety Net?

    Event Date:
    Event

    The Alliance for Health Reform and the Centene Corporation sponsored a July 23 briefing to discuss the role of community health centers (CHCs) in providing care to vulnerable populations as employer-sponsored coverage declines and demand for safety-net services increase. Panelists addressed questions such as: How are states and safety-net systems planning for 2014 and the challenges and opportunities presented under the ACA? Is there sufficient federal oversight of their operations? For more information, please visit…

  • Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs

    News Release

    Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three years. This year’s total is roughly half the size of last year’s $2 billion, in part because 2021 was a less profitable year and because…

  • ¿Me pueden cobrar primas más altas en el mercado si fumo? ¿Cuentan los cigarrillos electrónicos?

    FAQs

    En la mayoría de los estados, sí. Generalmente, una aseguradora puede cobrarle hasta un 50% más si ha consumido productos de tabaco cuatro o más veces por semana en promedio durante los últimos 6 meses. Esto se denomina recargo por tabaco. Por ejemplo, si la prima para alguien de su edad (antes de aplicar los subsidios) fuera de $200 al mes, si usted consume tabaco, su prima podría aumentar a $300 al mes. Las normas…

  • I’m enrolled in a student health plan, but now I think I can get a better deal in the Marketplace. Can I drop student health plan coverage and go to the Marketplace instead?

    FAQs

    If you are currently enrolled in a student health plan, you can still apply for Marketplace coverage during the annual Open Enrollment period. If your expected household income is at least $15,650 in 2026, you may qualify for premium tax credits; however, you will have to drop your student health coverage by December 31 to remain eligible for them. Outside of Open Enrollment, you cannot voluntarily drop your student health plan and qualify for Marketplace…

  • Kaiser Health Tracking Poll: Election 2008 – December 2007

    Poll Finding

    This December 2007 tracking poll finds finds that Iraq continues to top the list of issues that the public wants to hear presidential candidates talk about, with more than a third (35%) naming the war as one of the top two issues in an open-ended question. Health care (30%) ranks second, followed by the economy (21%) and immigration (17%). Health care ranks second behind Iraq for Republicans, Democrats, and independents alike. However, while health ranks…