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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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  • Advancing Opportunities, Assessing Challenges: Key Themes from a Roundtable Discussion of Health Care and Health Equity in the South

    Issue Brief

    This brief summarizes the primary themes expressed by participants of a roundtable discussion of current and future opportunities and challenges for advancing health care and health equity in the South organized by Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Georgia.

  • Health Coverage and Care in the South: A Chartbook

    Report

    The South has faced longstanding disparities in health and health care, although significant variation exists between southern states. As a group, compared to those in other regions, Southerners are more likely to be uninsured, less likely to have access to needed health services, and more likely to experience a number of chronic health conditions. This chartbook provides key data on the demographic and economic characteristics of the southern population as well as their health status, health insurance coverage, and access to care today.

  • Does the Affordable Care Act Cover the Uninsured?

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, discusses what a new Foundation survey finds about one of the biggest questions about the Affordable Care Act: whether it covers the uninsured.

  • Strategies in 4 Safety-Net Hospitals to Adapt to the ACA

    Issue Brief

    This brief examines four safety-net hospitals to learn how they were preparing for the full implementation of the Affordable Care Act (ACA), in order to gain additional insight into the strategies being used and challenges being faced among safety-net hospitals across the country.

  • Uncompensated Care for the Uninsured in 2013: A Detailed Examination

    Report

    This report provides estimates of spending for uncompensated care, in 2013, just before implementation of health reform’s major coverage provisions. The report estimates the amount of uncompensated care provided, analyzes the site of care for uncompensated services, and details sources of funding for uncompensated care. These estimates provide an important baseline against which to measure major changes that are occurring under the ACA.

  • The Affordable Care Act and Insurance Coverage in Rural Areas

    Issue Brief

    Rural populations face disparities compared to metropolitan populations in health care. While rural individuals were not more likely to be uninsured than metropolitan counterparts pre-Affordable Care Act, they were poorer and less likely to have private insurance. With coverage changes in the ACA involving an expansion of Medicaid for poor and near-poor populations, decisions by states with large rural populations may cause rural residents to have disparate access to coverage, which may exacerbate cost and access barriers to health care.

  • The Twin Goals of Health Insurance

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, examines a study finding Massachusetts' health reform saved lives in the context of health insurance's twin goal: better access to improve health and economic security.

  • Measuring Changes in Insurance Coverage Under the Affordable Care Act

    Issue Brief

    This data note discusses the details and timing of some of the private and federal surveys that will be used to look at how coverage has changed due to the Affordable Care Act. Different surveys offer different information and insight into coverage under the ACA, and we discuss the contributions and challenges in each type of effort.

  • Those Long Lines To Enroll In The ACA

    News Release

    In the latest post from the series Policy Insights, Kaiser Family Foundation President and CEO Drew Altman discusses the need for community based outreach to enroll the long term uninsured. All previous Policy Insights posts are archived online.

  • Those Long Lines To Enroll In The ACA

    From Drew Altman

    In this Policy Insight, Kaiser Family Foundation President and CEO Drew Altman discusses the need for community based outreach to enroll the long term uninsured.