Enrollment - Research and Data from KFF

Medicaid Enrollment & Spending Growth: FY 2018 & 2019

Oct 25, 2018

Issue Brief

This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2018 and 2019. Findings are based on interviews and data provided by state Medicaid directors as part of the 18th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) survey and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.

States with the Fastest Recent Growth in ACA Marketplace Coverage Started with High Uninsured Rates

May 16, 2024

News Release

The states with the fastest recent growth in ACA Marketplace signups also had among the highest uninsured rates previously, as enhanced subsidies helped to make coverage more affordable for many consumers, particularly in southern states that did not expand their Medicaid programs to cover low-income adults, a new KFF analysis finds.

Eliminating the Medicaid Expansion Federal Match Rate: State-by-State Estimates

Feb 13, 2025

Issue Brief

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.

Eliminating the ACA Medicaid Expansion Match Could Reduce Total Medicaid Spending by Up To $1.9 Trillion Over 10 Years and End Coverage for 20 Million People

Feb 13, 2025

News Release

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.

The Debate Over Federal Medicaid Cuts: Perspectives of Medicaid Enrollees Who Voted for President Trump and Vice President Harris

Feb 25, 2025

Report

The Republican-led Congress is considering plans to cut Medicaid to help pay for tax cuts, with the House budget resolution targeting $880 billion or more in potential reductions to federal Medicaid spending. To better understand the experiences of Medicaid enrollees and their perceptions of potential changes to the program, KFF conducted five virtual focus groups in January, including three groups with participants who had voted for President Trump in the 2024 election and two groups with participants who had voted for Vice President Harris.

Capping Per Enrollee Spending Could Reduce Federal Medicaid Expenditures by $532 billion to Nearly $1 Trillion Over 10 Years Depending on How States Respond and Result in as Many as 15 Million People Losing Medicaid Coverage by 2034

Feb 26, 2025

News Release

As Congress considers ways to cut Medicaid spending to help finance the extension of federal tax cuts, a new KFF analysis finds that imposing a cap on federal spending per Medicaid enrollee—known as a “per capita cap”—could trigger a decrease in federal Medicaid spending over a 10-year period of $532 billion to almost $1 trillion,…

ACA Marketplace Enrollment Has More Than Doubled Since 2020, with the Fastest Growth Occurring in States Won by President Trump in 2024

Apr 2, 2025

News Release

Enrollment in Affordable Care Act (ACA) Marketplace health plans reached a record 24.3 million people, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election, a new KFF analysis finds.

2025 California Health Benefits Survey

Nov 18, 2025

Report

The survey provides an in-depth look at trends in employer-sponsored coverage in California, including premiums, cost sharing, offer rates, and employer strategies to manage costs and access to care, including comparisons to the nation overall.

State-Based Efforts Will Provide Limited Relief from Enhanced Tax Credit Expiration

Jan 9, 2026

Policy Watch

After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating State-Based Marketplaces (SBMs), have been preparing for this possibility for months and are moving to blunt the impact on consumers by implementing their own state-funded subsidies and implementing other programs aimed at stabilizing the cost of unsubsidized premiums.

ACA Sign-Ups Are Down by Over a Million People, But It’s Still an Incomplete Picture

Jan 29, 2026

Quick Take

Data currently being released represent Open Enrollment Marketplace plan selections, or how many people have signed up for or been automatically renewed into 2026 coverage. These data do not necessarily translate to effectuated enrollments. That is because people who have selected a plan or been automatically renewed may not ultimately choose to pay for their plan, thus “effectuating” their coverage.

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