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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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  • Amid Repeal Debate, Public Views Obamacare More Favorably Than Unfavorably

    News Release

    Large Majorities Want to Continue Federal Funding for Medicaid Expansion; Two Thirds Favor Current Federal Role over Block Grants or Per-Capita Caps As President Trump and Congress weigh repealing the Affordable Care Act, the latest Kaiser Health Tracking Poll finds more Americans viewing the law favorably than unfavorably (48% compared to 42%). This is the highest level of favorability measured in more than 60 Kaiser Health Tracking Polls conducted since 2010. The shift largely reflects…

  • Primas y créditos impositivos bajo la Ley de Cuidado de Salud Asequible (ACA) vs el American Health Care Act (AHCA): Mapa Interactivo

    Interactive

    Estos mapas comparan los estimados de los créditos impositivos que los consumidores recibirían para pagar las primas en 2020, por condado, bajo la Ley de Cuidado de Salud Asequible (ACA) con lo que recibirían bajo el proyecto de líderes republicanos del Congreso llamado American Health Care Act (AHCA), que se dio a conocer el 6 de marzo.

  • Why Deductibles Would Rise Under the GOP Health Care Plan

    From Drew Altman

    This inaugural Drew Altman column for Axios examines how the GOP House bill would impact deductibles for people who buy insurance in the non-group market. A KFF analysis for the column shows deductibles in a typical non-group plan would be about $1550 higher under the American Health Care Act compared to the Affordable Care Act.

  • Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

    News Release

    Public Grows More Pessimistic About How Repeal Will Affect Them Personally Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill or not pass it all, finds the latest Kaiser Health Tracking Poll. Three in 10 (31%) of the public hold favorable views of the American…

  • Next Steps for CHIP: What is at Stake for Children?

    Fact Sheet

    The Children’s Health Insurance Program (CHIP) is an important complement to Medicaid, covering 8.4 million children with family incomes above Medicaid eligibility limits who often lack access to affordable private coverage. Following are key facts that highlight what is at stake for children if there is a failure to extend CHIP funding beyond September 2017 and based on changes proposed in the American Health Care Act (AHCA), which would fundamentally restructure Medicaid by capping federal…

  • State Data: What Has Happened to Health Coverage and Financing Under the Affordable Care Act?

    News Release

    As Congress presses forward with efforts to repeal and replace the Affordable Care Act, a new interactive map from the Kaiser Family Foundation provides a window into the changes in health insurance coverage and financing in each state under the 7-year-old law. The ACA increased enrollment in health insurance by expanding Medicaid, offering tax credits to low- and middle-income marketplace enrollees and reforming insurance market rules concerning coverage for people with pre-existing health conditions. Map…

  • Kaiser Health Tracking Poll – June 2017: ACA, Replacement Plan, and Medicaid

    Feature

    As the Senate prepares to vote on the Republican plan to repeal and replace the Affordable Care Act and limit federal Medicaid funding, a new Kaiser Family Foundation Tracking Poll finds the Affordable Care Act itself remains far more popular than the bill that would replace it. A majority of Republicans, however, continue to support the Republican plan, though by a significantly narrower margin than last month. Furthermore, the Tracking Poll finds that the most…

  • Premiums under the Senate Better Care Reconciliation Act

    Issue Brief

    This analysis provides estimates of how premiums, after taking into account tax credits, would differ in 2020 under the Senate's Better Care Reconciliation Act (BCRA) vs. the Affordable Care Act (ACA) for people currently enrolled in the federal and state insurance marketplaces.

  • Medicaid’s Role in Louisiana

    Fact Sheet

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

  • Data Note: Modestly Strong but Malleable Support for Single-Payer Health Care

    Feature

    The latest Kaiser Health Tracking poll finds that while there has been a modest increase in the public’s level of support for single-payer in recent years, a substantial share of the public remains opposed to such a plan, and opinions are quite malleable when presented with the types of arguments that would be likely to arise during a national debate.