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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  • Employer Family Health Premiums Rise 4 Percent to $17,545 in 2015, Extending a Decade-Long Trend of Relatively Moderate Increases

    News Release

    Since 2010, Deductibles for All Workers Have Risen Almost Three Times as Fast as Premiums and About Seven Times as Fast as Wages and Inflation Facing New Requirements, Few Employers Make Changes to Workers' Hours Menlo Park, Calif. – Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2015 Employer Health Benefits…

  • A Dose of Reality in the Virtual World of Health IT

    Event Date:
    Event

    The Alliance for Health Reform hosted a September 28 briefing to discuss electronic health records (EHRs), and the progress of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Speakers explored such questions as: How does health information technology fit in the strategy for health care delivery transformation? What role are EHRs playing in care coordination, accountable care organizations and other innovations? What are the special challenges facing solo and small physician practices?…

  • Even Supporters May Not Understand Medicare-for-All

    From Drew Altman

    In this Axios column, Drew Altman shows that the majority of supporters don’t know how Medicare-for-all works, with both positive and negative implications for support if they knew more.

  • Tracking the Role of Health Care in the 2020 Election: What Do The Polls Tell Us

    Perspective

    In this February 2020 post for The JAMA Health Forum, Mollyann Brodie and Ashley Kirzinger examine the role health care has played in the primary election to date, what the polling data says about the issue, including Medicare-for-all and a public option, and what to expect from the issue during the rest of the 2020 election campaign.

  • Innovations in Primary Care: What’s in the ACA?

    Event Date:
    Event

    The Patient Protection and Affordable Care Act aims to move the health care system away from an episodic, fee-for-service approach and towards a coordinated, preventive model of care delivery. Exactly how does the law encourage innovations in primary care? What roles will states and purchasers of care play in this transformation? This December 13 briefing, cosponsored the Alliance for Health Reform and The Commonwealth Fund, explored this and related questions. For more information, please visit…

  • Pulling it Together: Business and Health Care Costs

    Perspective

    Hidden away on page 218 of our annual Employer Health Benefits Survey is a table that shows what employers think of the main strategies they have to control health care costs.  More specifically, the table shows what the person in the firm responsible for its health benefits thinks, which is whom we survey.  The short answer is, employer confidence in their own ability to control costs is not high. Not more than about a quarter…

  • Chartpack: Kaiser Health Tracking Poll — December 2009

    Poll Finding

    This document contains the chartpack from the December Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted December 7 through December 13, 2009, among a nationally representative random sample of 1,204 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (403, including 111 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • December Kaiser Health Tracking Poll: Public Again Divided on ACA, Independents Polarized, and Exchanges Widely Popular

    Perspective

    According to the December Kaiser Health Tracking Poll, the October downturn in the share of Americans with a favorable view of the health reform law has been fully reversed in December and overall opinion on the law returned to the roughly even split seen for most of 2011. Forty-three percent of Americans expressed unfavorable views of the law in December, while 41 percent had favorable views. Partisan divisions persist and the findings suggest not only…

  • April Kaiser Health Tracking Poll: Core Views on ACA Remain Stable After Oral Arguments

    Perspective

    The increased public attention to the Affordable Care Act (ACA) generated by the Supreme Court’s consideration of the law did not meaningfully change the public’s opinion of the law overall or of the specific provision at the heart of the legal case against it, the individual mandate. Forty-two percent say they have a favorable opinion of the law this month and 43 percent have an unfavorable one, a division virtually unchanged from March. Similarly, the…