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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.

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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  • Data Note: Prescription Drugs and Older Adults

    Issue Brief

    This data note explores the attitudes and experiences of older adults, ages 65 and up, when it comes to prescription drugs and related policy proposals being discussed. Experiences across different demographic groups are explored, such as household income and health status.

  • The Democratic Debates Suffer from a Nasty Case of Plan-itis

    From Drew Altman

    In The Washington Post op-ed “The Democratic Debates Suffer from a Nasty Case of Plan-itis,” Drew Altman says the primary debates are not serving voters well by focusing on details of candidates' health care plans rather than the fundamental differences between them.

  • KFF Health Tracking Poll – July 2019: The Future of the ACA and Possible Changes to the Current System, Preview of Priorities Heading Into 2nd Democratic Debate

    Feature

    This month's KFF Health Tracking Poll explores public opinion towards a government-administered public option, and finds that attitudes can change after hearing common arguments. The poll also examines the public's views toward Medicare-for-all and the Affordable Care Act, as well as the top issues for Democrats ahead of the second round of presidential debates.

  • Poll: Strong Initial Support for a Public Option, But Arguments Can Significantly Shift Views

    News Release

    Health Care Remains a Top Issue for Democrats Heading into Next Debates; At This Stage, More Want to Hear About Candidates’ Difference than Contrasts with President Trump The 2020 presidential election may be shaping up to be another election cycle focused on health care, with Democratic candidates offering competing proposals aimed at expanding coverage and controlling costs and a pending legal battle over the constitutionality of the Affordable Care Act. The latest KFF tracking poll…

  • State Actions to Improve the Affordability of Health Insurance in the Individual Market

    Issue Brief

    A number of states have taken steps to provide consumers with more affordable coverage options in the individual market, including the marketplaces. Some states are implementing strategies that lower premiums by building on, and increasing the stability of the individual market, while other states are expanding the availability of lower cost coverage sold outside the marketplaces that does not comply with ACA standards—an approach that could increase marketplace premiums further. This brief examines these different…

  • Analysis: ‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

    News Release

    A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans. An even larger share (31%) could be affected when workers’ voluntary contributions to Flexible Spending Accounts are taken into account. The analysis comes as some in Congress are proposing to repeal the ACA’s tax on high-cost health plans,…

  • How Many Employers Could Be Affected by the High-Cost Plan Tax

    Issue Brief

    The high cost plan tax (HCPT) sometimes referred to as the Cadillac tax, is an excise tax on the cost of employer health benefit exceeding certain threshold. The HCPT provides a powerful incentive to control health plans costs over time, whether through efficiency gains or shifts in costs to workers. While many employers do not expect that the tax will take effect in 2022, others are already amending their health programs in anticipation. We estimate…

  • Uwe Reinhardt - Event - Page

    Uwe Reinhardt’s New Book Priced Out: His Health Policy Ideas in Today’s Debates

    Event Date:
    Event

    Dr. Uwe Reinhardt is a giant in the health policy field who advised policymakers and influenced debates about the nation’s health system before his passing in 2017. His recently released last book, Priced Out: The Ethics and Economics of Health Care, completed by his wife and longtime collaborator Tsung-Mei (May) Cheng gives us the gift of further insights into the U.S. health system and many issues that the country is debating right now, ranging from health price…