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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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  • State Medicaid Eligibility Policies for Individuals Moving Into and Out of Incarceration

    Issue Brief

    This brief highlights how state eligibility policies for incarcerated individuals differ, based on a review of state statutes, regulations, Medicaid eligibility manuals and other Medicaid agency guidance publicly available online and Medicaid managed care contracts. Overall, state Medicaid eligibility policies for justice-involved individuals moving into and out of incarceration vary, and these policies affect if and when individuals may enroll in Medicaid and the scope of any resulting savings.

  • 2015 Survey of Health Insurance Marketplace Assister Programs and Brokers

    Report

    This nationwide survey analysis of Marketplace consumer assistance programs and brokers examines the nature of Marketplace assistance during the second open enrollment period for 2015 coverage, and offers unique insights into how Affordable Care Act (ACA) implementation is progressing, what is changing, and what challenges remain. Building upon our Survey of Health Insurance Marketplace Assister Programs (2014), the analysis compares Assister Program capacity and experiences from the first open enrollment period to the next, and also includes the enrollment experience of brokers for the first time.

  • 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.

  • A Final Look: California’s Previously Uninsured after the ACA’s Third Open Enrollment Period

    Report

    The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracked the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. After each enrollment period concluded, a survey was conducted of the same group of previously uninsured Californians who participated in the baseline (a longitudinal panel survey). The fourth and final survey in the series, and the focus of this report, followed up with them after the third open enrollment period in spring 2016 to find out whether more have gained coverage, lost coverage, or remained uninsured, what barriers to coverage remain, how those who now have insurance view their coverage, and to assess the impacts that gaining health insurance may have had on financial security and access to care.

  • 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.

  • How the Midterms Factor Into Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how Democratic victories in several close gubernatorial races on Tuesday could revive efforts to expand Medicaid.