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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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  • Lacking Dental Coverage, Many People on Medicare Forgo Dental Care, Especially Beneficiaries of Color

    News Release

    Many people enrolled in Medicare go without dental care, especially beneficiaries of color, according to a new KFF analysis of dental coverage and costs for people with Medicare. Almost half of all Medicare beneficiaries (47%) did not have a dental visit within the past year as of 2018, the analysis finds, with rates higher among those who are Black (68%) or Hispanic (61%) compared to White beneficiaries (42%). Rates were also higher among those who…

  • Health Coverage and Care in the South in 2014 and Beyond

    Issue Brief

    This issue brief provides an overview of health coverage and care in the South today, with a focus on demographics, the impact of the ACA coverage expansions, and ongoing efforts to improve the delivery system and safety net in the South.

  • The Twin Goals of Health Insurance

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, examines a study finding Massachusetts' health reform saved lives in the context of health insurance's twin goal: better access to improve health and economic security.

  • More Than 6 in 10 of the Remaining 27.4 Million Uninsured People in the U.S. are Eligible for Subsidized ACA Marketplace Coverage, Medicaid or the Children’s Health Insurance Program

    News Release

    Recent policy attention has focused on efforts to reduce the number of uninsured people in the U.S. by expanding eligibility for coverage assistance, including enhanced premium subsidies in the Affordable Care Act (ACA) Marketplace and filling the Medicaid “coverage gap.” A new KFF analysis shows that a majority of the 27.4 million people who remained uninsured in 2020 already are eligible for financial assistance for coverage through Medicaid/CHIP or the Marketplace, suggesting that policies in…

  • Millions of Uninsured People Can Get Free ACA Plans

    Policy Watch

    This post estimates that about 5 million uninsured people across the country could get coverage through an Affordable Care Act (ACA) Marketplace health plan with virtually no monthly premium if they enroll during the 2023 open enrollment period, which runs through Jan. 15 in most states.

  • ¿Cómo aplico para recibir los subsidios para ayudarme a pagar las primas?

    FAQs

    Comience completando la solicitud de cobertura en línea en cuidadodesalud.gov. Esto podría ser más rápido, aunque también puede enviarla mediante una solicitud impresa por correo postal o llamando al centro de atención telefónica del mercado y solicitando por teléfono. Solicitar en línea es probablemente la opción más rápida. Para solicitar en línea, deberá crear una cuenta personal segura con un nombre de usuario y una contraseña. Haga clic aquí para obtener información sobre cómo configurar…

  • Navigating the Family Glitch Fix: Hurdles for Consumers with Employer-sponsored Coverage

    Issue Brief

    About 5 million people could benefit from the fix to the Affordable Care Act’s “family glitch” that allows workers offered unaffordable family coverage to get subsidies in the marketplace – if they can show they qualify. This brief looks at some of the challenges consumers may face in deciding whether to take advantage of the fix.