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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

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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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  • ¿Cómo funciona el período especial de inscripción por “matrimonio”?

    FAQs

    Cuando usted se casa, puede calificar para un período especial de inscripción (SEP, por sus siglas en inglés). Usted y su cónyuge pueden inscribirse para obtener cobertura en el mercado de seguros.El período especial de inscripción dura 60 días desde la fecha de la boda. Si usted se inscribe para obtener seguro a través de un SEP, la cobertura comenzará el primer día del mes siguiente.Si vive en un estado que utiliza cuidadodesalud.gov, aplican restricciones.…

  • ¿Puedo comprar un plan de salud en el mercado de seguros si no tengo la residencia permanente (green card o tarjeta verde)?

    FAQs

    Potencialmente, sí. Debe ser un inmigrante con presencia legal en el país para ser elegible para cobertura (como ser recipiente de una tarjeta verde o green card). Otros tipos de visa son de refugiados o asilados. La Acción Diferida para los Llegados en la Infancia (DACA) ya no se considera un estatus migratorio elegible para obtener cobertura médica a través de los Mercados de Seguros Médicos. Puede encontrar más información sobre los estatus migratorios elegibles…

  • ¿Quién puede comprar cobertura en el mercado de seguros?

    FAQs

    La mayoría de las personas pueden comprar cobertura en el mercado de seguros. Para ser elegible, debe vivir en el estado en donde está su mercado, debe ser ciudadano de los Estados Unidos o estar en el país de manera legal, y no debe estar preso o tener Medicare. La Acción Diferida para los Llegados en la Infancia (DACA) ya no se considera un estatus migratorio elegible para la cobertura de salud a través de…

  • ¿Qué es el mercado de seguros de salud?

    FAQs

    Los mercados de seguros (también conocidos como de intercambio) son mercados organizados en donde las personas y familias pueden buscar e inscribirse en un seguro médico en línea, por teléfono o en persona. Estos mercados ofrecen una variedad de planes de salud, certifican los planes participantes y brindan información para ayudar a los consumidores a comprender sus opciones y solicitar cobertura. Hay un mercado de seguros en cada estado. Algunos son administrados por el estado…

  • Community Health Centers: Growing Importance in a Changing Health Care System

    Issue Brief

    Community health centers provide essential access to comprehensive primary care in underserved communities. This issue brief describes health centers and their patients in 2016 and examines changes in access to care and utilization of services by health center patients following implementation of the ACA coverage expansions in 2014.

  • 2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates

    Issue Brief

    This brief summarizes premium rate filings in all 50 states and the District of Columbia and finds the majority of rate changes for 2021 are moderate, with increases or decrease of a few percentage points. Insurers say the COVID-19 pandemic is putting both upward and downward pressure on health costs in 2021.

  • Tracking Poll: A Large and Growing Majority, Including Republicans, Does Not Want the Supreme Court to Overturn the ACA’s Protections for People with Pre-Existing Conditions

    News Release

    As the Senate considers Judge Amy Coney Barrett’s nomination to the Supreme Court, the October KFF Health Tracking Poll finds a large majority (79%) of the public do not want the Court to overturn the Affordable Care Act’s protections for people with pre-existing medical conditions, up 17 percentage points since last year when 62% held this view. The Supreme Court is scheduled to hear arguments a week after Election Day in a challenge to the…