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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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  • Nearly 20 Million Children Live in Immigrant Families that Could Be Affected by Evolving Immigration Policies

    Issue Brief

    President Trump has intensified national debate about immigration by implementing policies to enhance immigration enforcement and restrict legal immigration. Recent findings show that the climate surrounding these policies has significantly increased fear and uncertainty among immigrant families, broadly affecting families across different immigration statuses and locations. The effects extend to lawfully present immigrants, including lawful permanent residents or “green card” holders, and children in immigrant families, who are predominantly U.S.-born citizens. In particular, findings point to both short- and long-term negative consequences on the health and well-being of children in immigrant families.
    Potential changes to public charge policies intended to reduce use of public programs by immigrant families, including their citizen children, could further increase strains on immigrant families and lead to losses in health coverage. To provide insight into the scope of potential impacts of continually evolving immigration policy on children, this data note provides nationwide and state-level estimates (Table 1) of citizen children living in immigrant families and the number currently covered by Medicaid/CHIP coverage.

  • The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey

    Report

    To date, there has been little research providing a quantitative look at the causes of medical bill problems and the impacts they have on people’s families, their finances, and their access to health care. To fill this gap, the Kaiser Family Foundation and The New York Times conducted an in-depth survey with 1,204 adults ages 18-64 who report that they or someone in their household had problems paying or an inability to pay medical bills in the previous 12 months.

  • Taking Stock and Taking Steps: A Report from the Field after the First Year of Marketplace Consumer Assistance under the ACA

    Report

    This report summarizes experiences of Marketplace assistance programs as they helped consumers enroll in coverage during the first Open Enrollment period under the Affordable Care Act. Insights about what worked and where improvements could help are drawn from discussions of assisters and other experts who participated in a Consumer Assistance Roundtable, jointly sponsored by the Kaiser Family Foundation and the Robert Wood Johnson Foundation in June, 2014.

  • 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.

  • Health Coverage and Care in the South in 2014 and Beyond

    Issue Brief

    This issue brief provides an overview of health coverage and care in the South today, with a focus on demographics, the impact of the ACA coverage expansions, and ongoing efforts to improve the delivery system and safety net in the South.

  • Kaiser Health Policy Tracking Poll: December 2014

    Feature

    With many of the Affordable Care Act’s (ACA) major provisions taking effect this past year, the December Kaiser Health Tracking Poll finds that many Americans are aware of the main parts of the law and, with the exception of the individual mandate, at least 6 in 10 feel favorably towards them. The poll finds the vast majority of the uninsured don’t know the deadline to enroll, most expect to get health insurance in the next few months, and nearly two-thirds say they don’t think they’ll have to pay a fine, or don’t know if they will, for not having coverage this year.

  • Web Briefing: Early Impacts of the Medicaid Expansion for the Homeless Population

    Event Date:
    Event

    The Affordable Care Act’s Medicaid expansion provides a significant opportunity to increase health coverage and improve access to care for individuals experiencing homelessness, who historically have had high uninsured rates and often have multiple, complex physical and mental health needs.

  • How 13 Million Americans Could Lose Insurance Subsidies

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on November 19, 2014. Kaiser Family Foundation calculations of how many Americans could lose subsidies in 2016 depending on the Supreme Court’s ruling in King v. Burwell. The Supreme Court is expected to rule next year on King v.

  • Kaiser Health Tracking Poll: November 2014

    Feature

    Following the Nov. 4 midterm elections, nearly half of Americans expect increased debate between the two parties over the Affordable Care Act. In comparison, 42 percent say the amount of debate will not change, and very few (5%) say it will decrease. Conducted just prior to the start of the ACA's second open enrollment season, the poll also probes the views of people without health insurance, one of the key target groups for outreach and enrollment efforts. It finds the uninsured remain largely unaware of the renewed opportunity to purchase or enroll in health insurance through the marketplaces over the next few months.

  • 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.