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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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  • My employer doesn’t offer health insurance. Can I buy a plan on the Marketplace and qualify for financial assistance?

    FAQs

    Yes, if your employer does not offer you health insurance, you can shop for a plan on the Marketplace instead. The annual Open Enrollment period to sign up for coverage runs from November 1 to January 15 in most states. Depending on your income and household information, you may qualify for premium tax credits and cost-sharing reductions to help offset your costs. If your income is very low, the Marketplace will also help determine if…

  • Trabajo con una visa H-2A. ¿Tengo derecho a cobertura en el mercado de seguros?

    FAQs

    Sí. Los inmigrantes con residencia legal que, de otro modo, serían elegibles para cobertura médica, incluyendo a los "no inmigrantes", como los trabajadores con visa H-2A y aquellos con visas de estudiante, pueden adquirir cobertura en los mercados de seguros. Quienes tengan bajos ingresos y sean elegibles también podrían recibir asistencia con las primas y reducciones en los costos compartidos para reducir el costo de la cobertura. Sin embargo, DACA ya no se considera un…

  • ¿Cuánto puedo ganar y calificar para subsidios para las primas en el mercado?

    FAQs

    Los subsidios para las primas están disponibles para quienes contratan una cobertura del mercado de seguros y cuyos ingresos son al menos iguales al nivel federal de pobreza. Para una persona, esto significa un ingreso de al menos $15.650 en 2026. Para una familia de cuatro, esto significa un ingreso de al menos $32.150 en 2026. Esta calculadora de subsidios del mercado de seguros puede mostrarle su elegibilidad para diferentes montos de ingresos y tamaños…

  • How an ACA Premium Spike Will Affect Family Budgets, and Voters

    From Drew Altman

    In his latest column, President and CEO Dr. Drew Altman shows how spiking premiums, which may come if the enhanced ACA tax credits are not extended, will hit people in the context of their family budgets, alongside rising costs for food, housing and utilities. For some families, their new health care costs could far exceed what they pay for food, affecting their economic security and potentially their vote.

  • Why Might Republicans Consider Extending Obamacare Tax Credits?

    Quick Insights

    KFF Vice President Cynthia Cox takes a broader look at the expiring enhanced tax credits, which Congressional Democrats have made central to their government funding demands, and how they lower health costs for many traditionally Republican constituencies, such as people in southern states, small business owners and employees, farmers and ranchers, older adults, and rural Americans.