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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

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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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  • Individual Market Enrollment Ticks Up in Early 2014

    Issue Brief

    This early look at the growth in the individual or nongroup market during the first three months of 2014 uses first quarter enrollment data submitted by insurance companies to state regulators to estimate the size of the market at the end of March. It includes both on and off exchange enrollment and is net of any people leaving the market (whether through plan cancellations or general churn in the market). It does not include the…

  • Summary of the Affordable Care Act

    Fact Sheet

    This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.

  • State Marketplace Profiles: Massachusetts

    Other Post

    Final update made on September 29, 2013 (no further updates will be made) Establishing the Marketplace On April 12, 2006, former Governor Mitt Romney (R) signed into law comprehensive health reform legislation designed to provide near-universal health coverage for state residents.1  The Massachusetts health reform law became the model for national health reform. An important component of the law was the creation of the Massachusetts Health Connector, a health insurance marketplace that manages several coverage programs.…

  • State Marketplace Profiles: West Virginia

    Other Post

    Final update made on October 24, 2013 (no further updates will be made) Establishing the Marketplace On February 15, 2013, Governor Earl Ray Tomblin (D) submitted a blueprint to Secretary Sebelius for West Virginia to establish a Partnership Marketplace with plan management responsibilities.1  In the previous year, Governor Tomblin had signed SB 408 into law to establish the West Virginia Health Benefits Exchange and the state had begun exploring implementation options for a state-based marketplace.…

  • State Exchange Profiles: Montana

    Other Post

    Final update made on April 19, 2013 (no further updates will be made) Establishing the Exchange In December 2012, Montana’s elected State Auditor Monica Lindeen (D) confirmed that the federal government would operate a health insurance exchange in Montana.1 The previous year, two proposed bills (HB620 and HB124) to establish a health insurance exchange in Montana failed.2,3 Instead, the legislature passed SB 228, a bill that would prohibit the creation of a health insurance exchange as proscribed…

  • State Exchange Profiles: Tennessee

    Other Post

    Final update made on December 10, 2012 (no further updates will be made) Establishing the Exchange On December 10, 2012, Governor Bill Haslam (R) announced Tennessee would default to a federally-facilitated health insurance exchange.1 Prior to the announcement that the state would not operate its own exchange, the Tennessee Department of Finance and Administration established the Insurance Exchange Planning Initiative to advise the Governor and Legislature on exchange implementation. The Initiative worked closely with a…

  • State Marketplace Profiles: Rhode Island

    Other Post

    Final update made on October 8, 2013 (no further updates will be made)  Establishing the Marketplace After the legislature failed to pass Marketplace legislation during the 2011 session, Governor Lincoln Chafee (I) signed Executive Order 11-09 on September 19, 2011, to establish the Rhode Island Health Benefit Exchange.1  In July 2013, Rhode Island announced that its Marketplace would be called HealthSource RI.2  Recommendations by the Rhode Island Healthcare Reform Commission largely informed the Governor’s decision to…