At least 11 states are offering extra premium subsidies to people buying health insurance through the Affordable Care Act marketplace in 2027. California, Colorado, Connecticut, Maryland, Massachusetts, New Mexico, New Jersey, Rhode Island, Vermont, Virginia, and Washington state are providing this funding on top of remaining federal subsidies.
The state programs come after enhanced federal ACA subsidies expired at the end of 2025. When those subsidies ended, average ACA premiums jumped 58 percent, rising to $178 per month in 2026 from $113 per month in 2025, according to research group KFF. ACA enrollment fell 13 percent, from 22.1 million people in February 2025 to 19.2 million in February 2026.
Rhode Island and Virginia are launching their programs for the first time in 2027. Most other states are continuing policies they started in 2026. California expanded eligibility to reach additional consumers.
Each state sets its own eligibility rules and assistance amounts. Many target lower-income households. In Washington state, enrollees with income up to 200 percent of the federal poverty line can receive up to $35 per month in state help, while those earning 201 to 250 percent of the poverty line can get up to $20 monthly.
California increased funding for its Covered California State Subsidy Program to $300 million in 2027 from $190 million in 2026, expanding eligibility to households earning up to 200 percent of the federal poverty level. This will make an additional 200,000 people eligible who weren't in 2026. Massachusetts boosted its investment to $620 million in 2027 from $600 million in 2026, calling it the largest state investment in the country.
New Mexico is the only state fully replacing the expired enhanced subsidies for ACA enrollees. The state was also the only one to see enrollment growth between 2025 and 2026, with a 14 percent increase.
States offering premium assistance saw smaller enrollment declines in 2026 than states without assistance. "States in 2026 that did offer assistance had smaller declines in enrollment," said Justin Lo, a senior researcher at KFF.