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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

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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  • Kaiser Health Policy News Index: April 2015

    Feature

    The health policy stories included in this month’s Kaiser Health Policy News Index were followed closely by about 4 in 10 Americans. Of the stories asked about this month, the one that garnered the most attention was coverage of the white police officer charged with the murder of an unarmed black man in South Carolina. Over half report closely following other stories, including the Germanwings plane crash in the French Alps, a new religious freedom…

  • Kaiser Health Tracking Poll: April 2015

    Feature

    This month’s Kaiser Health Tracking Poll finds public opinion of the Affordable Care Act (ACA) continues to be almost evenly split The poll also asks about health care priorities for the President and Congress, and the concern that comes out on top for Democrats, Republicans and independents alike is making sure that high-cost drugs for chronic conditions are affordable to those who need them. Other than high-cost prescription drugs, Democrats, Republicans and independents have different…

  • The Ryan White Program and Insurance Purchasing in the ACA Era: An Early Look at Five States

    Issue Brief

    This issue brief examines the role that the Ryan White Program has played in helping HIV positive clients purchase insurance coverage from both a historical and an Affordable Care Act (ACA) era perspective. The ACA era analysis focuses on activities in five states during the first open enrollment period and looks specifically at insurance purchasing through the health insurance marketplaces. The states analyzed are California, Florida, Georgia, New York, and Texas.

  • Decoding the HHS Reorganization

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman examines the implications of Secretary Kennedy’s reorganization of HHS and why it’s a sharp break from past efforts to reorganize the department.

  • I’m a few years away from turning 65 and becoming eligible for Medicare, and I would like to sign up for a Marketplace plan in the meantime. I am a lawfully-present immigrant, and I hear there&#82...

    FAQs

    In general, lawfully-present immigrants (except for DACA recipients) are eligible to buy a plan on the ACA Marketplace. The new law does not affect eligibility for Marketplace coverage for lawfully-present immigrants. Currently, depending on your income and household size, you may be eligible for premium tax credits to offset the cost of your premiums. However, beginning in 2027, the types of lawfully-present immigrants eligible for tax credits will become much more limited than it is…

  • 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.

  • The Role Health PLAYED in the Election

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman provides an early post-mortem on the role health played in the election, discussing the many ways it did play a role in the campaign — even if not a decisive one.

  • The Role of Health Care in the New Presidential Election

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman describes the role of health care in the new presidential election with Vice President Harris facing former President Donald Trump. He discusses how health will likely be a consequential factor in the campaign, with abortion and reproductive rights, along with health care costs, taking center stage.

  • The Two Big Decisions That Will Drive Health Policy

    From Drew Altman

    KFF’s president and CEO Drew Altman writes in a new column about the factors driving the biggest health policy decisions now—how to pay for tax cuts and whether President Trump wants another big fight about health care.

  • Unraveling the Mysteries of Biden vs. Trump on Health Care

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman unravels the differences between Trump and Biden on Medicare, abortion, drug costs and other health-related issues that KFF's new side-by-side candidate analysis examines. From the bird’s eye view, these differences amount to a fork in the road in direction on the role of the federal government in health and federal health spending.