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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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  • ACA Marketplace Enrollees Will See Steep Increases in Premium Payments in 2026 if Enhanced Subsidies Expire

    News Release

    Without the enhanced subsidies in the Inflation Reduction Act (IRA), Affordable Care Act (ACA) Marketplace enrollees in 12 of the states that use HealthCare.gov would see their annual premium payments at least double on average, according to a new KFF analysis. Enrollees in three states would see the steepest annual increases: Wyoming (195% or $1,872), Alaska (125% or $1,836), and West Virginia (133% or $1,404), and premiums would rise by an average of 93% or…

  • A Look at State Efforts to Ban Cellphones in Schools and Implications for Youth Mental Health

    Issue Brief

    Education leaders and policymakers are turning to cellphone bans in schools to help address youth mental health concerns and improve learning, an idea that has largely received bipartisan support. Cellphone ban legislation has had a resurgence following advisories from the U.S. Surgeon General on youth mental health and the impacts of social media. Research on the effectiveness of these bans, however, is limited, and challenges with implementation and enforcement remain.

  • KFF Health Tracking Poll: Public Views on Recent Tax and Budget Legislation

    Poll Finding

    KFF's Health Tracking Poll looks at awareness and perceived impact of the tax and budget law signed by Trump in July 2025. Nearly half of the public says that they expect the new law to generally hurt them and their families, about twice the share who say it will generally help. The law itself remains largely unpopular, with many more people holding unfavorable views than favorable ones.

  • My company provides funds for workers to buy health insurance on their own instead of providing health insurance through the company. Can I still qualify for premium tax credits to buy a Marketplace plan?

    FAQs

    Employees who receive funds to buy health insurance on the individual market can sometimes still qualify for premium tax credits, depending on the type of health reimbursement arrangement (HRA) their employer offers and its affordability to you: Employers with fewer than 50 workers may offer what’s known as a Qualified Small Employer HRA. If your employer offers this type of coverage arrangement and it is considered “affordable” based on your household income, you will not…

  • ¿Qué es un plan de salud para estudiantes?

    FAQs

    Un plan de salud estudiantil es un tipo especial de cobertura médica que las universidades ofrecen a sus estudiantes matriculados. Normalmente, un plan de salud estudiantil es diferente de la cobertura patrocinada por el empleador que las universidades ofrecen a su plantel de profesores y a su personal.

  • The Bigger Story, and Agenda, Behind GOP Changes to Obamacare, Medicare and Medicaid

    From Drew Altman

    This column was published as a Wall Street Journal Think Tank column on November 21, 2016. Early media coverage of the Republican health-care agenda has concentrated on plans to repeal and then replace the Affordable Care Act. The larger story is GOP preparations for a health policy trifecta: to fundamentally change the ACA, Medicaid and Medicare–all three of health care’s major programs–and in the process, fundamentally alter the direction of the federal role in health and core elements…

  • Drug Overdose Deaths Rose During the COVID-19 Pandemic, Particularly Among Black and American Indian/Alaska Native People

    News Release

    Drug overdose deaths rose during the early part of the COVID-19 pandemic, with some of the biggest jumps occurring among people of color, a new KFF analysis finds. The analysis breaks out drug overdose deaths by race and ethnicity for the first nine months of 2020, when the pandemic triggered widespread shutdowns and job losses, to the same period in each of the two prior years. Between 2018 and 2020, drug overdose death rates increased…

  • Most Americans Report a Personal Connection to Those Who Have Abused Prescription Painkillers; Whites More Likely To Be Affected Than Blacks or Hispanics

    News Release

    Poll Finds 9% Say a Family Member or Close Friend Died of an Overdose; 27% Say Either They or Someone Close to Them Has Been Addicted On the ACA This Month, 45 Percent View the Law Unfavorably and 38 Percent View It Favorably With prescription painkiller abuse garnering more attention from the media and policymakers, the latest Kaiser Family Foundation Health Tracking Poll finds most Americans have a personal connection to the issue. In total,…

  • Do Marketplace plans or Medicaid cover abortions?

    FAQs

    It depends on where you live and what type of coverage you have. For Marketplace plans, there is no federal requirement for plans to cover abortion. About half of states prohibit Marketplace plans from covering abortion. However, other states require plans to cover abortion services and do not permit cost sharing. For Medicaid enrollees, federal law only allows the use of federal funds for abortion in cases of rape, incest, or life endangerment of the pregnant…

  • When can I apply for Marketplace premium tax credits when other coverage is available?

    FAQs

    In general, if you have or are offered other comprehensive, affordable coverage, you may not be eligible for premium tax credits on the Marketplace. However, there are several circumstances where you may be eligible. This chart lays out examples of different coverage types and whether or not they will disqualify you for premium tax credits.