Affordable Care Act

The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

Did the Affordable Care Act Make Health Care More Affordable?

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?

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  • Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2017: Findings from a 50-State Survey

    Report

    This 15th annual 50-state survey provides data on Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in these policies in the past year. As discussion of repeal of the Affordable Care Act (ACA), broader changes to Medicaid, and reauthorization of CHIP unfolds, this report documents the role Medicaid and CHIP play for low-income children and families and the evolution of these programs…

  • Kaiser Health Policy News Index: 2016 in Review

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers better understand which health policy-related news stories Americans are following, and what the public knows about health policy issues covered in the news. This analysis examines the top health policy news stories in 2016.

  • Key Medicaid Questions Post-Election

    Fact Sheet

    This fact sheet provides insight into how a repeal of the Affordable Care Act (ACA) and changes in the financing structure would affect Medicaid, including the Medicaid expansion, and how a Trump administration could change Medicaid through administrative actions.

  • Data Note: Americans’ Opinions of the Affordable Care Act

    Feature

    In advance of the Affordable Care Act’s fourth open enrollment period beginning on November 1st, this Data Note examines the public’s views on the 2010 health care law, including which groups are perceived as better and worse off as a result and what sources individuals go to for information about the legislation.

  • Kaiser Health Tracking Poll: October 2016

    Feature

    This month’s Kaiser Health Tracking Poll examines top issues to voters in the presidential election and finds that while health care ranks low, voters report being aware of the differences between Clinton’s and Trump’s health care proposals. Findings also include a look at which health care issues the next president and Congress should prioritize, the future of the Affordable Care Act, as well as Americans’ views on the creation of a public health insurance option.

  • Data Note: Public’s Views of a National Health Plan

    Feature

    The Kaiser Family Foundation's Health Tracking Poll from October 2017 asked the public of their views of a national health plan, and whether they favor or oppose the implementation of such a program. While about half of the public favors having a national health plan, there is a strong partisan divide with the majority of Republicans strongly opposing such a plan and nearly half of Democrats strongly favoring the plan. This poll also asked the…

  • Kaiser Health Tracking Poll – March 2018: Non-Group Enrollees

    Feature

    This report explores the experiences of individuals who purchase their own insurance through the Affordable Care Act (ACA) marketplace. The poll finds marketplace enrollees are worried about the future of health insurance availability and costs in their areas, but most say their premiums have not increased this year and they are satisfied with their insurance options.

  • Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey

    Report

    This 16th annual 50-state survey provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2018. It takes stock of how the programs have evolved as the fifth year of implementation of the Affordable Care Act (ACA) begins, discusses policy changes made during 2017, and looks ahead to issues that may affect state policies moving forward. It is based on a survey of state…

  • Kaiser Health Tracking Poll – February 2018: Health Care and the 2018 Midterms, Attitudes Towards Proposed Changes to Medicaid

    Feature

    At a time when some states are considering changes to their Medicaid programs, the February Kaiser Health Tracking Poll measures Americans’ attitudes toward Medicaid and examines views on work requirements and lifetime limits on benefits. The poll also continues to find the public leaning favorably towards the ACA, with this month marking the highest level of favorability since 2010. When asked to say in their own words what health care issue they most want 2018…