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.

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

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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  • Brief Examines the COVID-19 Crisis’ Implications for Americans’ Mental Health

    News Release

    Nearly half (45%) of adults across the country say that worry and stress related to the coronavirus (COVID-19) pandemic are hurting their mental health, an early sign that the health and economic crises is likely to increase mental health problems and further stretch the system’s capacity. A new issue brief explores how the crises and related measures to protect public health, including social distancing, business and school closures, and shelter-in-place orders, are likely to affect…

  • Partying Spring Breakers Don’t Represent Most of America’s Young Adults

    Policy Watch

    While news stories accurately depict the actions of some young people on spring break, our latest national poll show they are not representative of young adults more broadly who largely say they are engaging in social distancing practices in response to the coronavirus pandemic.

  • KFF Health Tracking Poll – Early April 2020: The Impact Of Coronavirus On Life In America

    Report

    Fielded from March 25-30, this poll tracks how the rapidly unfolding coronavirus (COVID19) pandemic is affecting Americans, including health and economic impacts to date and worries about the future. This poll also examines the implications of the pandemic on the 2020 presidential election, including favorability of the ACA, Medicare-for-all and a public option.

  • Poll: 4 in 10 Americans Report Losing Their Jobs or Work-Related Income Due to the Coronavirus Crisis, Including More Than Half of Part-Time Workers

    News Release

    Americans, Regardless of Partisan Identity, Prioritize Slowing Coronavirus’ Spread over Restarting the Economy With coronavirus cases rising and businesses shutting down, four in 10 (39%) U.S. residents say they already have lost a job or income due to the crisis, the latest KFF Health Tracking Poll finds. This includes most part-time workers (54%), as well as nearly half of parents with children under age 18 (47%) and those paid hourly or by the job (45%).…

  • Why the U.S. Doesn’t Have More Hospital Beds

    From Drew Altman

    With much of the news focused on the surge capacity of the nation’s hospitals during the COVID-19 pandemic, Drew Altman’s Axios column examines why the nation has a shortage of hospital beds and what can be done about it.

  • Coronavirus Response and the Affordable Care Act

    Policy Watch

    This post examines the Affordable Care Act's impact 10 years after its enactment and how its provisions, especially those that expand coverage opportunities, could address the health threat and economic upheaval caused by the coronavirus pandemic.

  • Coronavirus Response and the Affordable Care Act

    Issue Brief

    This post examines the Affordable Care Act's impact 10 years after its enactment and how its provisions, especially those that expand coverage opportunities, could address the health threat and economic upheaval caused by the coronavirus pandemic.

  • The Affordable Care Act’s Enduring Resilience

    Perspective

    In this article in the Journal of Health Politics, Policy and Law, Larry Levitt examines the Affordable Care Act 10 years after it's enactment. The article notes that the law has taken numerous blows, yet due to its policy design and the political forces it has unleashed, the law has shown remarkable resilience.