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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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  • Understanding the Health Provisions in the Inflation Reduction Act

    Other Post

    President Biden signed the Inflation Reduction Act of 2022 into law on August, 16, 2022. KFF has several analyses relevant to understanding the health provisions in the legislation, as well as their potential impact on people. Among other measures, the legislation for the first time requires the HHS Secretary to negotiate prices for some top-selling drugs covered in Medicare. It also requires drug companies to pay rebates if prices rise faster than inflation for drugs…

  • Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act

    Policy Watch

    As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:

  • ACA’s Maximum Out-of-Pocket Limit Is Growing Faster Than Wages

    Issue Brief

    This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.

  • What would ACA Subsidies Have Been in 2022 if COVID-19 Relief Had not passed?

    Interactive

    This calculator is for illustration purposes and shows the tax credits and premiums that marketplace customers would have paid in 2022 if not for the enhanced subsidies included in the 2021 COVID relief legislation, the American Rescue Plan Act, (ARPA). The enhanced subsidies expire at the end of the year.

  • Firearms are the Leading Cause of Death for Children in the United States But Rank No Higher Than Fifth in Other Industrialized Nations

    News Release

    Firearms are now the number one cause of death for children in the United States, but rank no higher than fifth in 11 other large and wealthy countries, a new KFF analysis finds. Guns - including accidental deaths, suicides, and homicides - killed 4,357 children (ages 1-19 years old) in the United States in 2020, or roughly 5.6 per 100,000 children. In each of the peer countries, guns kill fewer children than motor vehicles, cancer,…

  • Marketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why

    News Release

    Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act requires insurers to report data about claims denials and appeals to encourage transparency about how insurance coverage works for enrollees. The analysis examines data released…