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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 ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare

    Issue Brief

    This brief explains the key AHCA provisions that would reshape the private market to more closely resemble the pre-Affordable Care Act period, and the effects of these changes on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

  • How Single Payer Helps Republicans Change the Subject

    From Drew Altman

    In this Axios column, Drew Altman analyzes the political pros and cons of single payer for Democrats and whether it will shift the focus from the Republicans' failed effort to repeal and replace  the Affordable Care Act to the Democrats new sweeping plan.

  • Kaiser Health Tracking Poll – September 2017: What’s Next for Health Care?

    Feature

    This poll finds large majorities across all parties say reauthorizing funding for the Children's Health Insurance Program (CHIP) is an important priority for Congress; however, a larger share of Republicans also say it is important for Congress to work on repealing and replacing the Affordable Care Act (also known as Obamacare). This month's Kaiser Health Tracking Poll also examines public support for a variety of competing health care policies aimed at improving or replacing the…

  • Five Ways the Graham-Cassidy Proposal Would Affect Women

    Fact Sheet

    The Graham-Cassidy Senate proposal to repeal and replace the Affordable Care Act that could have a far-reaching impact on women's health care access and coverage. A new fact sheet outlines the ways women could be affected.

  • Kaiser Health Tracking Poll: August 2013

    Feature

    As outreach efforts for enrollment in the health insurance marketplaces created by the Affordable Care Act (ACA) increase over the summer, the August Kaiser Health Tracking Poll finds that the public’s most trusted sources of information on the law are not necessarily the ones people are most likely to be hearing from.

  • Medicaid Expansion Through Marketplace Premium Assistance

    Fact Sheet

    This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

  • Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010

    Feature

    Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010 Download Source Kaiser Family Foundation analysis of 2010 insurer filings to the National Association of Insurance Commissioners and the California Department of Managed Health Care using the Mark Farrah Associates Health Coverage Portal TM. Market share was calculated as the percent of the state’s individual insurance market enrollment accounted for by each parent company (measured in member months)  

  • Translating The Medicaid Expansion Into Increased Coverage: The Role Of Application Assistance

    Event Date:
    Event

    Under the Affordable Care Act (ACA), beginning in 2014 all states will employ streamlined, technology-driven enrollment systems to help eligible people sign up for insurance affordability programs, including Medicaid, the Children's Health Insurance Program and the new health insurance exchange marketplaces. Even with these streamlined systems in place, application assistance will be important for helping to translate the ACA's Medicaid and other coverage expansions into increased coverage. The Kaiser Family Foundation's Commission on Medicaid and…

  • Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

    Issue Brief

    This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the…