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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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  • Do You Have the Facts About Medicare’s Financial Outlook for the Future?

    News Release

    Medicare is likely to be back on the federal policy agenda this year as Congress and President Trump pursue repealing and replacing the Affordable Care Act, and potentially consider options to reduce federal spending. When talking about Medicare, the nation’s federal health insurance program for 57 million people age 65 and over and younger people with disabilities, some policymakers often express concern that the program will soon be “bankrupt” and that rising spending is unsustainable.…

  • The Affordable Care Act After Six Years

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do. All previous Drew Altman columns are online.

  • 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.

  • ACA Open Enrollment: If You Are Low-Income

    Fact Sheet

    This fact sheet explains 2020 health coverage options that may be available to people who have low incomes, including Medicaid coverage or individual insurance plans through Affordable Care Act (ACA) marketplaces.

  • Challenges to Forecasting Obamacare Enrollment for 2015

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why 2015 enrollment in the Affordable Care Act’s marketplaces is very hard to predict. All previous columns by Drew Altman are available online.

  • Mapping Marketplace Enrollment

    Interactive

    This interactive zip code tool and map displays enrollment in the Health Insurance Marketplaces as a share of the potential market in small geographic areas across the country.

  • Media Availability on the U.S. Supreme Court’s King v. Burwell Decision

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call with key experts on the Affordable Care Act (ACA), state marketplaces and more to explain the U.S. Supreme Court's decision in the King v. Burwell case and to answer questions about its implications. The petitioners in the case are challenging the legality of premium and cost-sharing subsidies for low- and middle-income people buying health plans in 34 states where the federal government rather than the state…