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ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Jun 29, 2026

Quick Insights

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even…

How Medicare Negotiated Drug Prices Compare to Other Countries

Dec 19, 2024

Issue Brief

This analysis finds that Medicare's negotiated prices for 10 high-expenditure prescription drugs are lower than what private Medicare drug plans had been paying, but still much higher than the prices available in 11 other wealthy nations.. It is available on the Peterson-KFF Health System Tracker.

State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes

Nov 13, 2025

News Release

As states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.

What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge

May 11, 2026

Issue Brief

This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and program budgets.

As ACA Deadline Approaches, Some Price-Sensitive Consumers May Consider Switching to Short-Term Plans

Dec 8, 2025

Quick Insights

As the ACA open enrollment deadline approaches amid the expiration of the enhanced premium tax credits, nearly six in 10 Marketplace enrollees say they would not be able to afford $300 more in annual health care costs, which may lead some to alternative coverage products, such as short-term plans, a type of private coverage that tends to have lower premiums but few consumer protections and limited benefits.

Nearly 7 in 10 Medicare Beneficiaries Do Not Compare Coverage Options During Open Enrollment

Sep 26, 2024

News Release

With open enrollment less than a month away, a new KFF analysis suggests that the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans. It’s a decision that could have a significant impact on enrollees’ coverage and costs. The analysis of federal data shows that nearly 7 in 10 Medicare beneficiaries (69%) did not compare their Medicare coverage with other Medicare options…

A Closer Look at North Carolina’s Implementation of the 2025 Reconciliation Law Medicaid Provisions and Other Changes Amid Medicaid Budget Shortfalls

May 29, 2026

Policy Watch

This policy watch provides initial insight into how North Carolina is preparing to implement certain Medicaid provisions of the 2025 reconciliation law and how other policy changes may affect coverage and access to care.

Did the Affordable Care Act Make Health Care More Affordable?

Jul 9, 2026

Video

The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees.KFF’s Cynthia Cox examines the ACA's record and the broader underlying question it raises: what's a fair price for Americans people to pay for health care?

Affordability Is the Issue Now, But Look for the Uninsured to Make a Comeback

Apr 10, 2026

From Drew Altman

A new column on the uninsured from President and CEO Dr. Drew Altman explains: “The uninsured is not the most politically salient problem in health care now, that’s affordability, nor is it the non-problem some say it is. But it’s coming back. And the problem of the chronically ill uninsured is glaring.” Read more.

A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes

Nov 13, 2025

Report

This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.

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