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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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  • Quantifying the Effects of Health Insurance Rate Review

    Report

    This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses. Rate review programs require insurers in the small group and individual markets to submit proposed rate increase requests to state or federal regulators, who determine if the requests are reasonable. The report finds that one out of every five requests submitted to states in 2011 resulted…

  • Presidential Candidates’ Platforms Reflect Sharp Differences in Perspectives of Democratic and Republican Primary Voters on Health Care Problems

    Poll Finding

    Embargoed for release until:Wednesday, January 23, 2008 For further information contact: Kate Schoen, Kaiser, (650) 854-9400, kschoen@kff.orgTodd Datz, HSPH, (617) 432-3952, tdatz@hsph.harvard.edu Presidential Candidates’ Platforms Reflect Sharp Differences in Perspectives of Democratic and Republican Primary Voters on Health Care Problems Analysis Draws On Data From New Kaiser/Harvard Survey of Likely Voters in Early Primary States, As Well As 10 Recent National Polls With the next wave of presidential primary elections quickly approaching, researchers from Harvard…

  • Keeping Coverage Continuous: Smoothing the Path between Medicaid and the Exchange

    Event Date:
    Event

    A key challenge for those implementing the reform law is how to manage churning, when people cycle in and out of public programs as their income varies. What approaches are states and the federal government taking to minimize the disruption from churning? Will people be able to keep their provider as they move from Medicaid to private coverage and back? This briefing, sponsored by the Alliance for Health Reform and The Commonwealth, addressed these and…

  • California and Texas: Section 1115 Medicaid Demonstration Waivers Compared

    Fact Sheet

    This fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010. Both waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will…

  • Medicaid’s New “Health Home” Option

    Issue Brief

    This brief provides key information about the new option for state Medicaid programs to provide "health home" services for enrollees with chronic conditions. The option, established under the new health reform law, took effect on Jan. 1, 2011. Health homes are designed to facilitate access to and coordination of the full array of primary and acute physical health services, behavioral health care and long-term community-based services and supports. Brief (.pdf)

  • Health Care Costs Top the Public’s List of Financial Worries, and Those Who Are Struggling the Most Want to Hear Presidential Candidates Discuss Economic and Health Care Issues

    News Release

    At a time when kitchen table economic problems are on voters’ minds, unexpected medical bills and health care costs top the public’s list of financial concerns, and voters who are struggling to pay their monthly bills are the most eager to hear the presidential candidates talk about economic and health care issues, the latest KFF Health Tracking Poll finds. Nearly 3 in 4 adults say they are worried about being able to afford unexpected medical…

  • Testimony: State-Based Health Reform Efforts

    Event

    On June 16, 2008, Kaiser Family Foundation Vice President Gary Claxton testified about state-based health reform efforts as part of the Senate Finance Committee's Preparing For Launch Health Reform Summit. In his prepared testimony, he examined the role of Medicaid and the State Children's Health Insurance Program, as well as the way various federal laws and policies may limit innovation at the state level. Testimony (.pdf)

  • Toplines: Kaiser Health Tracking Poll: Election 2008 — October 2008

    Poll Finding

    This document contains the detailed toplines from the October Kaiser Health Tracking Poll: Election 2008 poll. The poll involved a nationally representative random sample of 1,217 adults ages 18 and older, including 1,115 adults who say they are registered to vote, who were interviewed by telephone between October 8 and 13, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points and plus or minus 4 percentage points…