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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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  • ¿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…

  • I used to be covered on my parents’ health plan, but I dropped off last year when I found other coverage. Now I’ve lost that other coverage and want to get back on my parents’ plan. Can I do...

    FAQs

    Yes, you can get back on your parents’ plan until you turn 26 if they have coverage through work, or before the end of the year you turn 26 if they have Marketplace coverage. You do not have to wait until the next Open Enrollment to enroll. Your parents' plan must offer you a special opportunity to re-enroll because you lost your other coverage. If your parents get their insurance through their employer, you have…

  • I’m a young adult and I need health insurance. What are my coverage options?

    FAQs

    A number of options may be available to you: If your annual income is $21,597 or less in 2026 (138% federal poverty level for a single adult), you may qualify for Medicaid coverage. Not all states have elected to expand Medicaid eligibility to this income level. Check with a navigator or another type of assister using Find Local Help, or check with your state Marketplace to learn more about Medicaid eligibility in your state.  If…

  • My employer won’t fill out the form on Healthcare.gov that asks about the affordability of the insurance the company provides. I think it’s unaffordable, and that’s why I’m not enrolled in it. Can...

    FAQs

    If, for any reason, you cannot obtain this information from your employer, you should report to the Marketplace what you know, yourself, about your eligibility for employer-sponsored coverage, the cost of that coverage, and whether it meets minimum value standards. The Marketplace will determine your eligibility for subsidies based on the information you provided or based on any information the Marketplace was able to obtain on its own through other follow-up with your employer.