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How Much and Why ACA Marketplace Premiums Are Going Up in 2026

This analysis of initial rate filings from all 50 states and DC shows ACA Marketplace insurers are proposing a median premium increase of 18% for 2026, more than double last year’s 7% median proposed increase. The analysis includes proposed rate changes by state and insurer.

Data and analysis

The Uninsured Population and Health Coverage

This Health Policy 101 chapter examines the share of the United States population who are uninsured, highlighting their demographics and the challenges they face because of the lack of coverage.

How Many Uninsured Are in the Coverage Gap?

This analysis estimates that 1.4 million uninsured individuals in the 10 states without Medicaid expansion, including many working adults, people of color, and those with disabilities, remain in the “coverage gap,” ineligible for Medicaid or for tax credits that would make coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • 10 Things to Know About Medicaid

    Issue Brief

    At the start of 2025, many issues are at play that will affect Medicaid coverage, financing, and access to care. While Medicaid was not discussed much on the campaign trail, Congress may consider big changes as part of tax and spending debates and the Trump administration may make changes to Medicaid through executive actions. Amid the potential changes, this brief highlights ten key things to know about Medicaid.

  • On Medicaid Expansion, History Matters

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman discusses the history of the battles over the ACA’s provisions that were designed to expand coverage for the uninsured, which helps explain the effort to cut federal funding for the Medicaid expansion today. The real underlying issues, he says, are the same divisions that have always plagued the debate about covering the uninsured.

  • Poll: Survey of the Non-Group Market Finds Most Say the Individual Mandate Was Not a Major Reason They Got Coverage in 2018, And Most Plan to Continue Buying Insurance Despite Recent Repeal of the Mandate Penalty 

    News Release

    Very Few Say They Would Want to Purchase a Short-Term Plan, A Regulation Being Drafted By The Trump Administration Nine in 10 enrollees in the non-group market say they intend to continue buying their own insurance even after being told that Congress has repealed the individual mandate penalty for not having coverage as of 2019,…

  • Compare the Candidates on Health Care Policy

    Feature

    The side-by-side comparison tool provides a quick overview of former President Trump's and Vice President Harris' records, positions, public statements, and proposed policies on a range of key health care topics.

  • New KFF Focus Groups Reveal Medicaid Enrollee Experiences During Unwinding

    News Release

    Over six months after the expiration of pandemic-era enrollment protections, at least 27 million Medicaid enrollees—or roughly one-in-three enrollees across the country—have completed their state’s eligibility renewal process for the program. Over 18 million people have had their coverage renewed and over 10 million have been disenrolled, as of November 8, 2023.

  • What Issues Will Uninsured People Face with Testing and Treatment for COVID-19?

    Fact Sheet

    With COVID-19 cases rising in the US, issues surrounding access to testing and treatment for uninsured individuals have taken on heightened importance. Efforts to limit the spread of the coronavirus in the United States are dependent on people who may have been exposed to the virus or who are sick getting tested and seeking medical treatment. However, the uninsured are likely to face significant barriers to testing for COVID-19 and any care they may need should they contract the virus.

  • How Many of the Uninsured Can Purchase a Marketplace Plan for Free in 2020?

    Issue Brief

    This analysis looks at how many of the remaining uninsured are eligible for premium subsidies that are large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. It estimates 28% of uninsured individuals who could shop on the ACA Marketplace, or 4.7 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2020.

  • What Options Exist If You’ve Lost Job-based Health Insurance? (Video)

    Video

    As unemployment skyrockets due to the COVID-19 pandemic, tens of millions of people are at risk of losing their job-based health insurance. However, the majority of people are eligible for other forms of health insurance coverage. Watch this two minute video to learn about the options: Medicaid, job-based coverage from a spouse or parent, ACA marketplace coverage, COBRA and short-term insurance plans.