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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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  • September Kaiser Health Tracking Poll: Pre-Existing Conditions

    Perspective

    With several elements of the ACA targeted toward individuals with pre-existing conditions, this month’s Kaiser Health Tracking Poll takes a closer look at this group. Fifty-two percent of Americans say that they or someone else in their household has what would be considered a “pre-existing condition,” and among this group, one in five (21 percent) say they or their family member has had difficulty getting health insurance because of this condition. Yet many of these people…

  • Kaiser Health Tracking Poll: Support for Health Reform Law Dips in October

    Perspective

    After remaining roughly evenly split for most of the last year and a half, this month’s tracking poll found a higher share of the public expressing negative views towards the health reform law. About half (51 percent) say they have an unfavorable view of the Patient Protection and Affordable Care Act (ACA), while 34 percent have a favorable view, a low point in Kaiser polls since the law was passed. While Democrats continue to be substantially…

  • CBO’s Estimate of Repealing Exchange Grants: The Importance of Being Effective

    Perspective

    The Congressional Budget Office (CBO) recently released an analysis of a bill that would repeal grants to states under the health reform law to help them establish health insurance purchasing exchanges. Not surprisingly, CBO finds that the bill would reduce federal spending due to the fact that expected grants won't be provided, to the tune of $1.9 billion over ten years. But, that's not the biggest effect on the federal budget. CBO also finds that…

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

    Perspective

    In the latest Kaiser Health Tracking Poll, nearly half of Americans say they are confused about the status of the health reform law. While 52 percent of the public is aware that health reform is still law, 22 percent think the law has been repealed and is no longer law and another 26 percent are not sure. Americans are still divided about what they want lawmakers to do on health reform. Three in ten say…

  • The Public, Health Care Reform, and Views on Repeal

    Perspective

    With the U.S. House of Representatives scheduled to vote on repeal of the health reform law next week, the latest Kaiser Family Foundation data note revisits some recent public opinion findings on the topic. Kaiser’s December Health Tracking Poll found the public divided on the question of repeal: one in four (26 percent) wanted to repeal the law in its entirety; 25 percent wanted to repeal parts of the law and keep other parts; one…

  • July Kaiser Health Tracking Poll: Public Still Divided on ACA, Few Believe the Law Will Improve Consumer Protections

    Perspective

    Overall public opinion on the health reform law remains unchanged this month, with 42 percent of Americans holding a favorable view and 43 percent an unfavorable view. Even though previous Health Tracking polls have consistently shown that consumer protections were one of the least controversial and most widely supported provisions of the health reform law, the July poll finds that just one in five Americans think the law will lead to improvements in consumer protections…

  • Kaiser Polling Data Note Finds Regional Differences in Views of Health Reform Law

    Perspective

    Based on the November Kaiser Health Tracking Poll, the latest KFF data note examines regional differences in Americans’ views of the new health reform law. Although many states in the American South and West stand to be disproportionately eligible for federal funds under the new law, the analysis finds that opinions of the law play out quite differently in these regions. Those living in the Western and Northeastern United States are more likely to view…

  • Kaiser December Tracking Poll: Public Remains Divided on Health Reform Law; Significant Number of People Struggle Financially

    Perspective

    As 2010 draws to a close, the latest tracking poll from the Kaiser Family Foundation shows the public still divided in their views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent have a generally unfavorable view of it. As the weak economy continues, the survey finds that a significant number of…