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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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  • Chartpack: Kaiser Health Tracking Poll — August 2009

    Poll Finding

    This document contains the chartpack 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 of…

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for their proposed high premium increases. The analysis shows that people buying health insurance on their own in the individual market…

  • Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries

    Issue Brief

    This issue brief identifies the major provisions in the Patient Protection and Affordable Care Act (ACA) that are designed to improve care and streamline service delivery for dual eligibles, the millions of low-income seniors and younger persons with disabilities who are enrolled in both the Medicaid and Medicare programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs; they comprise only 15 percent of total Medicaid enrollment…

  • April 2009 Health Tracking Poll

    Poll Finding

    The April Kaiser Health Tracking Poll finds that six in ten Americans continues to say that they or a member of their household have delayed or skipped health care in the past year. A solid majority of the public believes health care reform is more important than ever because of current economic problems. The country’s overall economic problems have not dampened their interest in pursuing health care reform: a solid majority of the public (59%)…

  • How Will Uninsured Parents Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured parents and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Pulling it Together: An Actuarial Rorschach Test

    Perspective

    Drew Altman, Larry Levitt, Gary Claxton My colleagues have worked on this column with me and I invited them to join me as authors. As with pretty much every other discussion of health care going back to the days of Roosevelt, the great reform debate of 2009 (and now 2010) has been distilled into an ideological battle over the role of government. A government-sponsored "public option" has been off the table for a while now,…

  • 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…

  • To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents

    Report

    To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents This report explores factors that appear to drive relatively high rates of hospitalizations, based on interviews with doctors, nursing home staff and families in four cities. Key factors include liability concerns, limited onsite staff capabilities, difficulty reaching residents' physicians for care instructions on nights and weekends, better and more timely access to diagnostic tests in hospitals, and patient preferences. Physicians with patients…

  • 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…