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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  • 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…

  • State Marketplace Profiles: Kentucky

    Other Post

    Final update made on November 11, 2013 (no further updates will be made) Establishing the Marketplace On July 17, 2012, Governor Steven L. Beshear (D) issued Executive Order 587 establishing the Kentucky Health Benefit Exchange (KHBE) after the Supreme Court ruled to uphold the Affordable Care Act (ACA).1  In May 2013, the state announced that its online Marketplace would be called kynect. Prior to the Executive Order, the Kentucky Cabinet for Health and Family Services led Marketplace…

  • Poll: Public Divided on Repealing Obamacare, But Few Want It Repealed Without Replacement Details

    News Release

    As Congress begins to work on repealing and replacing the Affordable Care Act, the latest Kaiser Health Tracking Poll finds that one in five Americans (20%) support repeal alone, while three quarters either oppose repeal altogether (47%) or want to wait to repeal the law until the replacement plan’s details are known (28%). Overall, the poll finds that nearly equal shares say that the next Congress should vote to repeal the law (49%) and that…

  • Majority of the Public Say They Haven’t Been Affected By the Health Reform Law

    News Release

    Democrats More Likely to Say They Have Been Helped By the Law, Republicans More Likely to Say They Have Been Hurt Republican Voters Want ACA Debate to Continue, Democrats Would Rather Hear Candidates Talk About Issues Like Jobs, Independents Are More Split More than four years after the Affordable Care Act's enactment and more than a month after the close of open enrollment, six in 10 Americans (60%) say the health reform law has not…

  • Survey of Non-Group Health Insurance Enrollees

    Report

    Executive Summary January 1, 2014 marked the beginning of several provisions of the Affordable Care Act (ACA) making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces (also known as “Exchanges”) and the availability of premium and cost-sharing subsidies for individuals with low to moderate incomes. Data from the Department of Health and…

  • Health Care Costs: A Primer

    Issue Brief

    This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers.

  • What a Break in the Obamacare Battles Could Bring

    News Release

    Following the Supreme Court’s King v. Burwell decision, the Affordable Care Act could use a break from the intense political heat, though it may not get a long one as the 2016 election season heats up and presidential candidates play to their bases on health care, writes Drew Altman in his latest column for The Wall Street Journal’s Think Tank. All previous columns by Drew Altman are available.

  • Kaiser Health Tracking Poll: April 2014

    Feature

    Despite the news that 8 million people have signed up for health insurance through the ACA’s new marketplaces, the April Kaiser Health Tracking Poll finds no change in overall opinion of the law since last month . The most common reason for remaining uninsured is not being able to find an affordable plan. Also, a majority of the public supports the ACA’s requirement that private health insurance plans cover the full cost of birth control…