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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

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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  • Innovations in Primary Care: What’s in the ACA?

    Event Date:
    Event

    The Patient Protection and Affordable Care Act aims to move the health care system away from an episodic, fee-for-service approach and towards a coordinated, preventive model of care delivery. Exactly how does the law encourage innovations in primary care? What roles will states and purchasers of care play in this transformation? This December 13 briefing, cosponsored the Alliance for Health Reform and The Commonwealth Fund, explored this and related questions. For more information, please visit…

  • Kaiser Analysis: Estimated Health Insurance Rebates Under the Health Reform Law Total $1.3 Billion in 2012

    News Release

    NEWS RELEASEApril 26, 2012 Rebates Expected to Vary Significantly by State MENLO PARK, Calif. – Consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act (ACA), finds a new analysis from the Kaiser Family Foundation of the latest estimates provided by insurers to state insurance commissioners. The rebates include $541 million…

  • Family Health Premiums Rise 4 Percent to Average of $15,745 in 2012, National Benchmark Employer Survey Finds

    News Release

    Menlo Park, Calif. – Annual premiums for employer-sponsored family health coverage reached $15,745 this year, up 4 percent from last year, with workers on average paying $4,316 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2012 Employer Health Benefits Survey released today. This year’s premium increase is moderate by historical standards, but outpaced the growth in workers’ wages (1.7 percent) and general inflation (2.3 percent). Since…

  • A Dose of Reality in the Virtual World of Health IT

    Event Date:
    Event

    The Alliance for Health Reform hosted a September 28 briefing to discuss electronic health records (EHRs), and the progress of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Speakers explored such questions as: How does health information technology fit in the strategy for health care delivery transformation? What role are EHRs playing in care coordination, accountable care organizations and other innovations? What are the special challenges facing solo and small physician practices?…

  • The Texas Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006

    Other Post

    Health Affairs Article: The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006 A Foundation study featured as a web-exclusive Health Affairs article examines health coverage trends from 2000-2006 showing that over this period the dominant factor contributing to a rise in the uninsured population has been the decline in employer-sponsored insurance, even as the economy rebounded from the last recession. Access web-exclusive Health Affairs article

  • Medicare’s Role in Health-Care Payment Reform

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman explores whether Secretary Burwell's announcement this week about Medicare's payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform. All previous columns by Drew Altman are available online.