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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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  • Kaiser Health Tracking Poll — December 2011

    Poll Finding

    The October downturn in the share of Americans with a favorable view of the health reform law, a dip driven by an erosion of support among Democrats, has been fully reversed in December, with support among Democrats rebounding and overall national opinion on the law returning to the roughly even split seen in Kaiser polls for most of 2011.  The concept of health exchanges, a key piece of the law, has wide, bipartisan support.  The…

  • Health Insurance Premiums in the Individual Market in 2010

    Feature

    Health Insurance Premiums in the Individual Market in 2010 Download Source Kaiser Family Foundation analysis of 2010 insurer filings to the National Association of Insurance Commissioners using the Mark Farrah Associates Health Coverage Portal. The Average premium is calculated as total premium revenues in a state divided by the number of total member months. The per member per month premium is an average across adults and children, so will be lower than a premium typically…

  • How Many Are Affected?

    Feature

    How Many Are Affected? Download Source Kaiser Family Foundation  

  • How Much and Why ACA Marketplace Premiums Are Going Up in 2025

    Issue Brief

    This analysis of insurers' preliminary rate filings shows that ACA Marketplace insurers are requesting a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024. Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025.

  • Do I have to renew Medicaid coverage every year?

    FAQs

    Yes. States must redetermine Medicaid eligibility for most enrollees every 12 months. When your coverage period is ending, you will receive a notice from the state. If your coverage has been automatically renewed, the notice will indicate the new coverage period. If your coverage has not been automatically renewed, the notice will include instructions for completing the renewal process. Note that the renewal process might look different depending on where you live. Click here for a…

  • People in ACA Marketplaces Who Say They Benefited or Were Negatively Affected By ACA

    Feature

    People in ACA Marketplaces Who Say They Benefited or Were Negatively Affected By ACA Download Source Analysis of Kaiser Family Foundation Survey of Non-Group Health Insurance Enrollees, Wave 3 (Feb. 9-Mar. 31, 2016) Related: Column/Op-Ed: Partisanship’s Grip On The Affordable Care Act Survey of Non-Group Health Insurance Enrollees Early Release Methodology

  • I have been trying to get pregnant. Do Marketplace plans cover infertility services?

    FAQs

    The ACA does not require health plans to cover infertility services; however, some states require certain plans to cover certain infertility services. If you need these services and are shopping for coverage, check the plan details or your state insurance department about coverage and out-of-pocket costs for infertility care.

  • Who can buy a Catastrophic Plan?

    FAQs

    In general, Catastrophic plans may only be sold to young adults under the age of 30. However, there are certain financial hardship and affordability exemptions for people ages 30 and older, including if there is no qualified health plan offered on or off the Marketplace that would cost less than 8.05% of their income in 2026, or if they are not eligible for premium tax credits or cost-sharing reductions based on their projected annual income.…

  • What is a Catastrophic health plan?

    FAQs

    A “Catastrophic plan” is a qualified health plan offered on or off the Marketplace that covers the “essential health benefits.” While Catastrophic plans have lower premiums than other qualified health plans, they also have the highest level of cost sharing allowable for an ACA-compliant plan. For 2026, the annual deductible for covered services in a Catastrophic plan is $10,600 for an individual or $21,200 for a family. The plan does not have to cover more…