Affordable Care Act

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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  • Employer Family Health Premiums Rise 4 Percent to $17,545 in 2015, Extending a Decade-Long Trend of Relatively Moderate Increases

    News Release

    Since 2010, Deductibles for All Workers Have Risen Almost Three Times as Fast as Premiums and About Seven Times as Fast as Wages and Inflation Facing New Requirements, Few Employers Make Changes to Workers' Hours Menlo Park, Calif. – Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2015 Employer Health Benefits…

  • Data Note: Changes in 2017 Federal Navigator Funding

    Issue Brief

    This data note analyzes federal funding changes for Affordable Care Act (ACA) marketplace navigators in 2017 and discusses the implications for both the navigators and consumers. It presents results of a Kaiser Family Foundation online survey of federal marketplace (FFM) navigator programs and includes insights from a roundtable meeting of more than 40 navigators co-hosted by the Robert Wood Johnson Foundation and Kaiser Family Foundation.

  • Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act.

  • A Dose of Reality in the Virtual World of Health IT

    Event Date:
    Event

    The Alliance for Health Reform hosted a September 28 briefing to discuss electronic health records (EHRs), and the progress of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Speakers explored such questions as: How does health information technology fit in the strategy for health care delivery transformation? What role are EHRs playing in care coordination, accountable care organizations and other innovations? What are the special challenges facing solo and small physician practices?…

  • The Texas Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • Even Supporters May Not Understand Medicare-for-All

    From Drew Altman

    In this Axios column, Drew Altman shows that the majority of supporters don’t know how Medicare-for-all works, with both positive and negative implications for support if they knew more.

  • Tracking the Role of Health Care in the 2020 Election: What Do The Polls Tell Us

    Perspective

    In this February 2020 post for The JAMA Health Forum, Mollyann Brodie and Ashley Kirzinger examine the role health care has played in the primary election to date, what the polling data says about the issue, including Medicare-for-all and a public option, and what to expect from the issue during the rest of the 2020 election campaign.