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The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

About the ACA

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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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  • Media Availability on Senate Health Bill

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call Tuesday, June 27, with key experts to explain the Senate Republican health bill and to answer questions about its implications and the CBO’s scoring of the bill. During the call, Kaiser's experts  answered reporters' questions about the bill’s potential impact and implications, including how premiums, tax credits, and insurer participation in the ACA’s marketplaces could change; how the bill would phase out federal funding for the…

  • Now Available: Summary of Senate Repeal/Replace Bill in 17 Key Areas

    News Release

    An interactive tool from the Kaiser Family Foundation now includes a detailed summary of the Senate’s new discussion draft, the Better Care Reconciliation Act, a plan released Thursday to repeal and replace the Affordable Care Act (ACA). With the tool, users can compare the Senate bill to current law and the House-passed American Health Care Act in 17 key areas of health policy, including Medicaid, premium subsidies to individuals, state role, financing, women’s health, and…

  • New County-Level Map Compares Premiums and Tax Credits Under Senate Health Bill and ACA

    News Release

    A new interactive map from the Kaiser Family Foundation compares county-level estimates of premiums that consumers would pay under the Affordable Care Act (ACA) in 2020 with what they’d pay under the Senate’s discussion draft, Better Care Reconciliation Act (BCRA), a replacement plan unveiled last Thursday. The maps include premium and tax credit estimates by county for current ACA marketplace enrollees at age 27, 40, or 60 with an annual income of $20,000, $30,000, $40,000,…

  • Medicaid’s Role in West Virginia

    Fact Sheet

    This fact sheet provides data on Medicaid's role in West Virginia. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect West Virginia.

  • Medicaid’s Role in Alaska

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Alaska. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Alaska.

  • Medicaid’s Role in Tennessee

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Tennessee and describes how implementing a per capita cap or block grant would affect Tennessee.

  • What Are the Implications for Medicare of the American Health Care Act and the Better Care Reconciliation Act?

    Issue Brief

    This issue brief highlights a major implication of the American Health Care Act and Better Care Reconciliation Act for Medicare. Both bills would repeal the Affordable Care Act provision to increase the payroll tax on high-income earners. Repealing this surtax would move up the insolvency date of the Medicare Part A trust fund by 2 years, from 2028 to 2026, and also worsens the program's long-term financial outlook.