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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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  • Si no he declarado impuestos el año anterior, ¿cómo determinará el mercado de seguros de salud mis ingresos?

    FAQs

    Si un solicitante no presentó impuestos en un año anterior, el mercado de seguros de salud verificará los ingresos mediante el uso de datos salariales electrónicos. Si la información no se puede verificar electrónicamente, se le puede pedir al solicitante que presente documentación impresa adicional dentro de los 90 días, como recibos de pago, un contrato de trabajo u otra verificación de ingresos. A partir del próximo año, si no ha presentado impuestos federales sobre…

  • Estoy cubierto por el plan de salud de mis padres, pero pronto cumpliré 26 años y no podré seguir en su plan. ¿Qué opciones tengo?

    FAQs

    Debe revisar sus opciones de cobertura e inscribirse en una nueva ahora mismo. Si sus padres obtienen su seguro a través de un empleador con al menos 20 trabajadores, podría continuar con esa cobertura (conocida como COBRA) hasta por 3 años, pero probablemente sea mucho más costosa que otras opciones. Si trabaja, averigüe si su empleador ofrece seguro médico y si cumple los requisitos. De lo contrario, dependiendo de sus ingresos, podría ser elegible para…

  • ¿Qué es el Formulario 8962?

    FAQs

    El formulario 8962 es un formulario que debe presentar con su declaración de impuestos federal durante un año si recibió un crédito fiscal para pagar las primas por adelantado a través del mercado de seguros de salud durante ese año. En la inscripción abierta, cuando solicita un crédito fiscal para la prima para el próximo año, el monto de su crédito fiscal adelantado se basa en su ingreso estimado para el próximo año. Al año…

  • El plan de salud de mi empleador tiene una opción de bienestar que me obliga a pagar una prima más alta si no cumplo con ciertos objetivos de salud o si no participo en absoluto. No puedo pagar esas pri...

    FAQs

    Eso depende. Si su contribución a la prima con la penalización por bienestar sería superior al 9.96% de sus ingresos en 2025, entonces el plan de su empleador se consideraría inasequible y usted sería elegible para solicitar créditos fiscales para las primas en el mercado de seguros. Esta prueba se aplica independientemente de que usted sea realmente sancionado o no, y antes de que se aplique la sanción (por ejemplo, si su empleador le da…

  • ¿El período de inscripción abierta es el mismo para Medicare y los mercados de seguros de salud?

    FAQs

    Existe cierta superposición en los períodos de inscripción para Medicare y los mercados de seguros, pero este año no son los mismos. El período de inscripción abierta de Medicare se extiende del 15 de octubre al 7 de diciembre de cada año. Para la cobertura del mercado de 2026, el período de inscripción abierta se extenderá desde el 1 de noviembre de 2025 hasta el 16 de enero de 2024 en los estados que utilizan…

  • Which lawfully present immigrants qualify for Marketplace coverage?

    FAQs

    Lawfully present immigrants generally include: lawful permanent residents (or “green card holders”); persons fleeing persecution, including refugees and asylees; other humanitarian immigrants, including those granted temporary protected status; Cuban/Haitian entrants; survivors of domestic violence, trafficking, and other serious crimes; and persons with valid non-immigrant visas, such as work or student visas. Deferred Action for Childhood Arrivals (DACA) recipients are no longer eligible for ACA Marketplace coverage. For a list of qualified immigration statuses for the…

  • Will getting health insurance through Medicaid, CHIP, or the health insurance Marketplaces affect an individual’s ability to obtain lawful permanent resident status or citizenship?

    FAQs

    Some people who apply for a green card (lawful permanent residence) or a visa to enter the U.S. must pass a “public charge” test, which looks at whether the person is likely to become primarily dependent on the federal government as demonstrated by the use of cash assistance programs for income maintenance or government-funded institutionalized long-term care. In making this determination, immigration officials consider certain factors in their totality, including a person's age, family status, income…

  • I have been trying to get pregnant. Do Marketplace plans cover infertility services?

    FAQs

    The ACA does not require health plans to cover infertility services; however, some states require certain plans to cover certain infertility services. If you need these services and are shopping for coverage, check the plan details or your state insurance department about coverage and out-of-pocket costs for infertility care.

  • Who can buy a Catastrophic Plan?

    FAQs

    In general, Catastrophic plans may only be sold to young adults under the age of 30. However, there are certain financial hardship and affordability exemptions for people ages 30 and older, including if there is no qualified health plan offered on or off the Marketplace that would cost less than 8.05% of their income in 2026, or if they are not eligible for premium tax credits or cost-sharing reductions based on their projected annual income.…

  • What is a Catastrophic health plan?

    FAQs

    A “Catastrophic plan” is a qualified health plan offered on or off the Marketplace that covers the “essential health benefits.” While Catastrophic plans have lower premiums than other qualified health plans, they also have the highest level of cost sharing allowable for an ACA-compliant plan. For 2026, the annual deductible for covered services in a Catastrophic plan is $10,600 for an individual or $21,200 for a family. The plan does not have to cover more…