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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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  • I estimate my income next year will be very low, so I need my premium tax credit all paid in advance. If, by the end of the year, it turns out my annual income was even lower than I expected and I could...

    FAQs

    No, your final premium tax credit amount will be determined based on your income for the year as reported on your tax return. The fact that it ended up being less than you expected does not mean you have to repay the advance premium tax credit paid on your behalf, even if you could have qualified for Medicaid. In fact, your final credit amount will likely be larger than the amount you received in advance.…

  • What are premium tax credits and how do they work?

    FAQs

    Premium tax credits reduce your premium for most Marketplace plans. The amount of the tax credit you may receive depends on your income and the cost of Marketplace health plans in your area. The Marketplace will determine the expected contribution you are required to pay toward the premium for a mid-range (Silver) benchmark plan. The expected contribution will increase on a sliding scale based on your 2026 income, with more financial assistance for enrollees with…

  • Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?

    FAQs

    Yes. Many insurers that offer plans through the ACA Marketplace also offer identical plans outside of the Marketplace that meet all ACA standards, although premium tax credits and cost-sharing subsidies are not available for plans sold outside of the Marketplace. Some people prefer to buy health insurance outside of the Marketplace when they are sure they won’t qualify for financial assistance. Like health insurance plans sold on the Marketplace, “ACA-compliant” plans sold outside of the…

  • I received a Form 1095-C in the mail. What’s that?

    FAQs

    Form 1095-C will indicate your name and the name of your employer, the months when you were eligible for coverage, and the cost to you of the cheapest monthly premium you could have enrolled in under your employer’s health plan. If you worked for a large employer that did not offer its full-time employees health coverage, Form 1095-C will also indicate that. Keep this form with your tax records. You may need this form if…

  • How can I find out if my doctor is in a health plan’s network?

    FAQs

    Every plan Marketplace plan must provide a link to its health provider directory on the Marketplace website to its health provider directory so consumers can find out if their health care providers are included. The provider network information from insurance companies must also tell you whether a provider is accepting new patients. Some insurers' provider directories may list the languages spoken by providers, but this is not federally required. If your state uses HealthCare.gov (federally-facilitated…

  • What is the health insurance Marketplace?

    FAQs

    Health insurance Marketplaces (also known as Exchanges) are organized markets where individuals and families can shop for and enroll in health insurance online, over the phone, or in person. Marketplaces offer a choice of different health plans, certify plans that participate, and provide information to help consumers understand their options and apply for coverage. There is a health insurance Marketplace in every state. Some are operated by the state and have a special state name (such as…

  • ¿Qué es el formulario 8962?

    FAQs

    Si recibió un subsidio anticipado para pagar las primas (APTC) a través del mercado el año pasado, debe presentar un formulario 8962 con su declaración de impuestos federal para conciliar sus ingresos estimados y reales del año, incluso si calculó sus ingresos con precisión. Puede obtener un formulario 8962 en blanco en el sitio web del IRS o, si utiliza un software de preparación de impuestos, el formulario se generará automáticamente. Las instrucciones del formulario…

  • Estoy embarazada y quiero inscribirme en el mercado de seguros. ¿Cómo puedo calcular el tamaño de mi hogar para el próximo año e inscribir a mi bebé?

    FAQs

    Durante la inscripción abierta, aplicará como un hogar de un solo miembro (o de dos si se inscribe con su cónyuge). Cuando nazca el bebé, podrá actualizar la información de su familia en el mercado de seguros para que refleje que se ha convertido en una familia de dos (o de tres si se inscribe con su cónyuge). Después del nacimiento, tendrá un período de inscripción especial de 60 días para agregarlo a su plan.…

  • Escuché que los planes de salud tienen que cubrir servicios sin costos compartidos. ¿Esto incluye a todos los servicios preventivos? ¿Hay límites o excepciones a lo que cubren?

    FAQs

    La mayoría de los planes de salud, incluidos los del mercado de seguros, deben cubrir una amplia gama de servicios preventivos y no pueden imponer costos compartidos (como deducibles, copagos o coaseguros). La Ley de Cuidado de Salud a Bajo Precio (ACA) exige que los planes privados cubran servicios en cuatro categorías generales: Exámenes y asesoramiento basados ​​en la evidencia Vacunas de rutina Servicios preventivos infantiles Servicios preventivos para mujeres Siempre que el servicio preventivo…