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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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  • Women's Health Coverage promo

    How Does Where You Work Affect Your Contraceptive Coverage?

    Interactive

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including FDA approved prescription contraceptives and services for women. Legal challenges and recently issued rules have affected contraceptive coverage for many women.

  • On Health Care, Conservatives Protest Too Much

    From Drew Altman

    Lately conservatives have been feeling like losers in health care and complaining loudly about it. They don't like Obamacare or the increase in the government's role in health care or the federal spending it brings with it, even if those things result in coverage for more than 30 million uninsured Americans and new protections from the worst abuses in the health insurance industry. Actually, conservatives are winning at least as much as they are losing…

  • KFF February Health Tracking Poll: Nearly Half Confused About Status of the Health Reform Law

    Perspective

    The latest Kaiser Health Tracking poll finds that amid a public debate about contraceptive coverage in insurance plans, 63 percent of Americans support a new federal requirement that plans include no-cost birth control, while a third oppose it. Catholics split along similar lines, but there’s a big partisan divide, including among women: 85 percent of women who are Democrats support the requirement, compared with 42 percent of women who are Republicans. The public is also divided…

  • Kaiser Survey Probes Health Insurance Brokers’ Views on Insurance Trends, ACA

    Perspective

    A new nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets by the Kaiser Family Foundation explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums and deductibles for individuals and small businesses purchasing health insurance. When asked to estimate what they expect to be the typical premium increase in 2012…

  • Open Enrollment: Insights from Medicare for Health Insurance Marketplaces

    News Release

    In the latest post in the Policy Insights series, Tricia Neuman draws on the experiences of Medicare beneficiaries during Medicare’s annual enrollment period to consider whether consumers with health insurance coverage through the Affordable Care Act’s new marketplaces will shop for a better deal during their open enrollment season. Previous columns in the Policy Insights series are also available on kff.org.

  • Medicare-for-All’s Popularity May Have Peaked

    From Drew Altman

    In this Axios column, Drew Altman looks at the polling trend on support for Medicare-for-all suggesting it may have crested as criticism has mounted. He considers what it means for the Democratic primary and continued debate for Medicare-for-all and other expansion proposals.