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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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  • Medicare and Dental Coverage: A Closer Look

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. This brief provides new data on the share of Medicare beneficiaries with dental coverage, the share with a dental…

  • Survey: Adjusting to Sudden Reduction in Federal Funds, ACA Navigators Expect to Decrease Services

    News Release

    Many navigator organizations responsible for helping consumers understand and sign up for health coverage in 2018 Affordable Care Act (ACA) marketplaces say steep federal funding reductions that recently took effect will likely force them to limit their geographic service area, cut back outreach and public education, lay off staff members, and curtail other assistance, according to a new Kaiser Family Foundation survey of such programs. The navigators’ planned adjustments are in response to the government’s…

  • How Might Changes to the ACA Marketplace Impact Enrollees with Mental Health Conditions?

    Issue Brief

    This brief estimates the number of current Marketplace enrollees with a mental health diagnosis to understand what changes in enrollment may mean for access to services. Among the 24.3 million Marketplace enrollees in 2025, over 4.4 million individuals are estimated to have at least one mental health diagnosis on a health care claim.

  • ¿Qué tipos de planes médicos venden los sitios web de inscripción privada?

    FAQs

    Los sitios web de inscripción privada administrados por compañías de seguros generalmente solo muestran los planes que ofrece esa aseguradora. Los sitios web administrados por corredores de seguros deben mostrar todos los planes ofrecidos por varias aseguradoras. Si tiene preguntas o inquietudes sobre la información en estos sitios, comuníquese con el centro de atención telefónica del mercado, con cuidadodesalud.gov o con el mercado de su estado. Muchos sitios web de inscripción privada también venden planes…

  • Explaining the Muddle on ACA Tax Credits

    From Drew Altman

    In his latest column, KFF’s President and CEO Dr. Drew Altman looks at why the issue of extending the enhanced ACA tax credits has languished in Congress without clear direction, despite its importance to the 24 million people who get their coverage in the ACA Marketplaces today and the potentially significant role the issue could play in the midterms if the credits are not extended.

  • What Do They Mean When They Talk About Pre-Existing Health Conditions?

    Perspective

    One health care issue about which the presidential candidates acknowledge they have differences is how the health care system should treat people with pre-existing health conditions. People who have a health condition (such as an illness or pregnancy) or who are at higher than average risk of needing health care are referred to as having a pre-existing health condition. The insurance reform provisions of the Affordable Care Act (ACA), when they take effect in 2014, will…

  • August Kaiser Health Tracking Poll: A Look At The GOP As The Republican Convention Draws Near

    Perspective

    Despite the ongoing focus on Republican opposition to the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds that the ACA is not the top health care priority among Republicans. While jobs are still the number one issue, when asked about the health care issues that will impact their vote this fall, Republicans’ top concern was the cost of health care and insurance, named by two-thirds as either “extremely” or “very important” to…

  • March Kaiser Health Tracking Poll: The ACA at Two Years; The Individual Mandate and the Supreme Court

    Perspective

    As the Patient Protection and Affordable Care Act (ACA) nears its second birthday, the latest Kaiser Health Tracking Poll finds that public opinion on the law remains evenly split (41 percent favorable, 40 percent unfavorable) with sharp divisions along partisan lines, much as it has been since the law was passed. With the Supreme Court preparing to hear challenges to the law later this month, about half the public thinks the Court should strike down the…