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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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  • Medicaid Spending Growth and the Great Recession, 2007-2009

    Fact Sheet

    This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending. Fact Sheet (.pdf)

  • Kaiser Health Tracking Poll — November 2009

    Poll Finding

    The November Kaiser Health Tracking Poll shows little movement in measures of public opinion about health reform from recent months. Among the new findings is a ranking of the public's top priorities from among a list of elements of the legislation. There were both similarities and differences in priorities across partisan groups: while assuring the availability of affordable plans ranked in the top three priorities for Democrats, Republicans and independents, deficit neutrality ranked in the…

  • Health Care in the 2008 Presidential Primaries

    Poll Finding

    This analysis find that the sharply contrasting health care platforms of the leading Democratic and Republican presidential candidates reflect dramatic differences in the perspectives of their primary voters. The article analyzes a newly released Kaiser/Harvard survey of likely primary voters in 35 states (and the District of Columbia) with January or February primaries or caucuses, as well as data from 10 other recent surveys by national media polling organizations. The article, "Health Care in the…

  • Pulling it Together: What Conservatives Are Winning

    Perspective

    Conservatives are out of sorts these days about the direction in which health care is headed. They think the new health reform law expands the role of government too much and spends too much at a time when they believe deficit reduction should be a higher priority. The claims about death panels and a government takeover of the health system aside, these are principled positions for conservatives to take – they are supposed to be…

  • Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

    Event Date:
    Event

    The Alliance for Health Reform and The Commonwealth Fund co-sponsored this briefing to explore the health reform proposals being considered which may impose responsibilities on both individuals and employers to have and help pay for coverage and whether they will be able to pay the amounts above the subsidies. Questions addressed include:If Congress exempts people from the coverage requirement or significantly reduces the penalties for noncompliance, will enough healthy individuals purchase new coverage to adequately…

  • 2024 Calculadora del Mercado de Seguros Médicos

    Feature

    2024 Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de su familia para obtener un estimado de…