Affordable Care Act

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

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • 5 Million More Older Americans Would Become Uninsured under the House GOP Health Bill, and Many with Coverage Would Pay Steep Increases in Premiums 

    News Release

    As a group, older Americans are likely to see some of the biggest changes in their health insurance under the House-passed American Health Care Act (AHCA). The Congressional Budget Office projects that the number of 50- to 64-year-olds who are uninsured would rise to 10 million in 2026, about 5.1 million more than the number who would be uninsured under current law. Many of those who do have coverage would see steep increases in premiums…

  • U.S. Public Opinion on Health Care Reform, 2017

    Feature

    This slideshow supports a Visualizing Health Policy infographic with JAMA, spotlighting public opinion on health reform in the United States as of 2017, including priorities and views of the Affordable Care Act (also known as Obamacare) and its provisions.

  • Three Quarters of the Public, Including a Majority of Trump Supporters, Want President Trump to Try to Make the Affordable Care Act Work

    News Release

    Americans See Many Factors Behind AHCA’s Failure, But Few Republicans Blame President Trump Despite divided views about the Affordable Care Act, three-fourths of the public (75%) say President Trump and his administration should do what they can to make the law work, while one in five (19%), including 38 percent of Republicans, say the Administration should do what it can to make the law fail so they can replace it later, the latest Kaiser Health…

  • A Warning From the Polls About Letting Obamacare “Explode”

    From Drew Altman

    In this column for Axios, Drew Altman sees a warning for the Trump administration and Republicans in the latest Kaiser Tracking Poll: the more they do to undermine the Affordable Care Act marketplaces the more the public is likely to hold them, and not the Democrats, accountable for the problems with the law.

  • The Other Implication of the CBO Report: Election-Year Pain

    From Drew Altman

    In this Axios column, Drew Altman lays out how the “political pain” from the American Health Care Act would play out over the next two election cycles if passed in its current form, based on the Congressional Budget Office’s analysis of the House-passed bill.

  • Analysis: Strong Favorable Views of ACA Increased in Spring 2017, Strong Unfavorable Views Remain Flat

    News Release

    Since the passage of the Affordable Care Act in 2010, Kaiser Family Foundation polling has found the public divided in their overall views of the law and in the intensity of their opinions: For seven years, the share of the public holding strongly unfavorable views of the law has outnumbered the share with strongly favorable views. A new analysis of Kaiser Family Foundation polling data finds that intensity gap started to close in spring 2017, as…

  • August Kaiser Health Tracking Poll: The Uninsured and the Health Reform Law

    Perspective

    The August Kaiser Health Tracking Poll finds that even though 32 million uninsured Americans will gain health insurance under the ACA, only about half of non-elderly Americans currently without coverage say they are familiar with the chief components in the law designed to achieve this goal. Fifty-two percent of the uninsured say they are aware the law will provide subsidies to help low- and moderate-income people without insurance purchase it. And 47 percent are aware that…

  • More Support Than Oppose Their State Expanding Medicaid

    Feature

    More Support Than Oppose Their State Expanding Medicaid Download Source Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health, The Public’s Health Care Agenda for the 113th Congress (conducted January 3-9, 2013)