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A new KFF analysis finds that a congressional proposal to significantly cut federal spending on the Affordable Care Act’s Medicaid expansion could reduce total Medicaid spending by up to nearly one-fifth, or $1.9 trillion, over a 10-year period, and end Medicaid coverage for as many as 20 million people.
This analysis examines the potential impacts on states and Medicaid enrollees of eliminating the 90% federal match rate for the Affordable Care Act (ACA) expansion. Eliminating the federal match rate for adults in the Medicaid expansion could reduce Medicaid spending by nearly one-fifth ($1.9 trillion) over a 10-year period and up to nearly a quarter of all Medicaid enrollees (20 million people) could lose coverage.
This analysis of preliminary rate filings from 318 insurers across all 50 states and DC finds that small businesses with Affordable Care Act (ACA)-compliant plans could face a median premium increase of 11% for 2026.
The ACA enhanced premium tax credit has driven growth in Marketplace enrollment and offset declines in Medicaid coverage, holding 2024's 8% uninsured rate at its near-historic low, according to new Census Bureau data.
This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.
In 2025, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.
Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
Overall enrollment in the individual market fell 5% to 13.7 million in the first quarter of 2019 following the repeal of the ACA’s individual mandate penalty.
Overall enrollment in the individual market fell 5% to 13.7 million in the first quarter of 2019 following the repeal of the Affordable Care Act’s individual mandate penalty.
This analysis measures changes in enrollment in the individual market, including those in both marketplace plans and off-exchange plans, before and after the ACA’s coverage expansions and market rules went into effect in 2014 through the first quarter of 2019.
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