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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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • We’ve Never Seen Health Care Cuts This Big

    Perspective

    In this July 1 column for The New York Times Opinion section, KFF Executive Vice President for Health Policy Larry Levitt explains how the budget reconciliation bill passed by the Senate on July 1 is effectively a partial repeal of the Affordable Care Act (ACA) and, if signed into law, the resulting reductions in Medicaid and ACA Marketplace coverage would make it "the biggest rollback in federal support for health coverage ever."

  • 5 Key Facts About Medicaid and Veterans

    Issue Brief

    Medicaid helps fill gaps in coverage for veterans who are low-income, have disabilities, or are otherwise ineligible for military health benefits. It supports those with complex health needs and reduces out-of-pocket expenses. This brief presents five key facts about veterans with Medicaid and how policy changes in Congress could affect their coverage and access to care.

  • How Affordability of Employer Coverage Varies by Family Income

    Issue Brief

    This analysis looks at the share of family income people with employer-based coverage pay toward their premiums and out-of-pocket payments for medical care. The cost of employer sponsored health insurance—including premiums, deductibles, and other out-of-pocket costs—has risen steadily over time.

  • Fraud in Marketplace Enrollment and Eligibility: Five Things to Know

    Issue Brief

    This brief evaluates what is currently known about fraud and abuse in the Affordable Care Act (ACA) Marketplace, including how the final Marketplace Integrity and Affordability Rule and the recently enacted budget reconciliation law change existing Marketplace enrollment and eligibility standards.