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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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  • Infographic: How Does Where You Work Affect Your Contraceptive Coverage?

    News Release

    The Affordable Care Act’s requirement that most private health insurance plans provide contraceptive coverage has been the focus of ongoing litigation in the federal courts. In response to recent Supreme Court actions in the Hobby Lobby and College of Wheaton cases, the U.S. Department of Health and Human Services issued an interim final rule and a proposed rule on August 22, 2014 addressing how some employers with religious objections to birth control can comply with…

  • Premiums Set to Decline Slightly for Benchmark ACA Marketplace Insurance Plans in 2015

    News Release

    Analysis of 15 States and D.C. Also Finds Changes Vary Across States and Insurers Results Suggest Consumers Should Shop Carefully When Open Enrollment Begins November 15 MENLO PARK, Calif. -- An early look at the cost of health insurance in 16 major cities finds that average premiums for the benchmark silver plan – the one upon which federal financial help under the Affordable Care Act to consumers is based – will decrease slightly in 2015. …

  • A Perilous Gap in Health Insurance Literacy

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how progress in expanding coverage requires greater attention to the problem of health insurance literacy.

  • A Perilous Gap In Health Insurance Literacy

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, A Perilous Gap In Health Insurance Literacy, Drew Altman discusses how progress in expanding coverage requires greater attention to the problem of health insurance literacy. All previous columns by Drew Altman are available online.

  • Sen. Mark Pryor Spotlights the Health Law’s Rx for Pre-Existing Illnesses

    From Drew Altman

    In a column for The Wall Street Journal’s Think Tank, Drew Altman explains why Senator Mark Pryor’s new campaign ad features the Affordable Care Act’s protections for people with pre-existing medical conditions, the somewhat forgotten “mega provision” of the law.

  • Sen. Mark Pryor Spotlights the Health Law’s Rx for Pre-Existing Illnesses

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why Senator Mark Pryor’s new campaign ad features the Affordable Care Act’s protections for people with pre-existing medical conditions, the somewhat forgotten “mega provision” of the law. All previous columns by Drew Altman are available online.

  • How Obamacare Is Doing Better But Feeling Worse  

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why even as there are recent positive indicators of the Affordable Care Act’s performance and impact, public opinion about the law has not changed since passage of the law. All previous columns by Drew Altman are available online.