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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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  • How Will the Uninsured in Rhode Island Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Rhode Island, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Rhode Island are eligible for Medicaid or financial…

  • New Spanish-Language Cartoon and Calculator to Help Consumers Understand Health Insurance

    News Release

    The Kaiser Family Foundation today released two new Spanish-language tools to help consumers better understand health insurance as they shop for plans during open enrollment for the Affordable Care Act’s marketplaces and in other venues. El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!, is a Spanish version of the five-minute cartoon video Health Insurance Explained – The YouToons Have It Covered, a light-hearted treatment of a difficult and important topic. It breaks down…

  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election.

  • Explaining the 2015 Open Enrollment Period

    Issue Brief

    The brief provides an overview of what consumers can expect during the second annual Open Enrollment period under the Affordable Care Act (ACA), which runs from November 15, 2014 through February 15, 2015. It is the second opportunity for uninsured individuals to enroll in private insurance coverage, premium tax credits and cost sharing subsidies and the first time that people newly insured in 2014 can renew their health plan coverage and subsidies. It also overlaps…

  • An Early Look at the Affordable Care Act and Women

    News Release

    On Thursday, May 15 at 9:30 a.m. ET, the Kaiser Family Foundation will host a public briefing to release a new report based on the Foundation’s most recent comprehensive survey on women’s health.  This report provides new findings that will be critical to understanding women’s early experiences with the coverage changes that are part of the Affordable Care Act, including the latest information on:  Private and public insurance coverage rates for women  Use of preventive…

  • Tuve cobertura del mercado en 2025 y tengo que conciliar mis impuestos de este año. ¿Cuál es el máximo que tendría que reembolsar al IRS?

    FAQs

    Para el año fiscal 2025, si subestimó sus ingresos y recibió un subsidio para las primas anticipado mayor al que le correspondía, deberá reembolsar la diferencia entre el monto del crédito fiscal recibido y el monto al que tenía derecho. Sin embargo, si sus ingresos son inferiores a cuatro veces (400%) el nivel federal de pobreza, existen límites en dólares sobre el monto que deberá reembolsar para créditos pagados a las aseguradoras en su nombre.…

  • What about premiums I already paid in 2021?

    FAQs

    The higher premium subsidies are in effect for the 2021 and 2022 plan years.  For premiums you already paid in 2021, before the new law passed, you can claim the increased tax credit when you file your federal income tax return.