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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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  • How ACA Marketplace Costs Compare to Employer-Sponsored Health Insurance

    Issue Brief

    This analysis compares ACA Marketplace costs to employer-sponsored health insurance costs and finds that individual market premiums have become more similar to employer-sponsored premiums over time. In 2024, individual market insurance premiums averaged $540 per member per month, slightly below the average $587 per member per month premium for fully-insured employer coverage. The analysis uses data from Mark Farrah Associates Health Coverage Portal to compare average premiums in the individual and group insurance markets. The…

  • Poll: Support for Extending the Expiring Enhanced ACA Tax Credits Remains High, But Dips Among Republicans and MAGA Supporters as Shutdown Continues and Partisanship Takes Hold

    News Release

    As the government shutdown continues, public support remains high for extending the enhanced ACA tax credits set to expire at the end of the year, with three quarters (74%) of the public in favor of extending them, a new KFF Health Tracking Poll finds. The expiring tax credits are a central issue in the ongoing Congressional budget standoff, as Democrats want the tax credits extended as part of a budget deal while Republicans want to…

  • KFF Health Tracking Poll: Public Weighs Political Consequences of Health Policy Legislation

    Poll Finding

    KFF's Health Tracking Poll finds that more than three-quarters of the public say they want Congress to extend the ACA enhanced premium tax credits that are set to expire at the end of this year. If the credits do expire and the average premium more than doubles, seven in 10 of those who purchase their own insurance say they would not be able to afford premiums without significantly disrupting their household finances.

  • Do I have to enroll in coverage using HealthCare.gov, or can I apply for Marketplace plans and subsidies on websites run by private companies that sell Marketplace plans?

    FAQs

    HealthCare.gov permits the sale of Marketplace plans through websites run by private companies. These are sometimes described as “direct enrollment” sites or “certified enrollment partner” sites. These websites may be operated by a health insurance company, such as Blue Cross, Ambetter, or Molina. Other websites are operated by web brokers (such as GetInsured.com and Health Sherpa) who are health insurance agents and brokers. Enrolling for coverage through a private website does not disqualify you for…

  • 2025 Calculadora del Mercado de Seguros Médicos

    Feature

    Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de su familia para obtener un estimado de su elegibilidad…

  • Again, No Medicaid

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman explains why Medicaid, despite former President Donald Trump's silence on the topic, warrants greater attention given the potential for drastic changes or cuts to it should Republicans win control in the election.

  • I learned that my Medicaid coverage has ended. What do I do now?

    FAQs

    If you lose Medicaid but think you still qualify, contact your Medicaid agency. If your coverage ended less than 90 days ago, you may be able to submit any required forms and documents and have your coverage reinstated. If your coverage ended more than 90 days ago, you will likely need to reapply for Medicaid. If the Medicaid agency says you are no longer eligible for Medicaid but you believe that decision was made in…

  • The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election

    Issue Brief

    As the Trump administration reaches the end of its first term, this issue brief considers the landscape of approved and pending Section 1115 Medicaid demonstration waivers under this administration and how the November 2020 presidential election may impact this landscape.