The independent source for health policy research, polling, and news.
KFF’s policy research provides facts and analysis on a wide range of policy issues and public programs.
KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the organization’s core operating programs.
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.
In his latest column, president and CEO Drew Altman discusses why debate about extending the ACA enhanced tax credits set to expire this year has been slow to develop, and why it could matter to Republicans politically if the tax credits are not extended.
In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”
This analysis examines early indicators of how the expiration of enhanced premium tax credits has affected effectuated enrollment levels (i.e., enrollment among people who have paid their premiums), plan selections, and out-of-pocket costs in 2026, drawing on plan selection and effectuated enrollment data from the Centers for Medicare & Medicaid Services (CMS) and state-based Marketplace (SBM) Open Enrollment reports, as well as KFF survey data and individual market enrollment estimates from Wakely Consulting Group.
The average Affordable Care Act (ACA) Marketplace deductible experienced the steepest increase in history—growing by 37% or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired, according to a new KFF analysis. After the enhanced tax credits ended, many Marketplace shoppers shifted toward lower-premium, higher-deductible plans.
The Trump administration this week backed off a key element of its Medicare Advantage rate proposal, resulting in billions of dollars in additional payments to private insurers.
This issue brief presents findings on policy decisions related to implementation of Medicaid work requirements. The findings draw on information from the annual survey of state Medicaid and CHIP program officials conducted by KFF and the Georgetown University Center for Children and Families for the 43 states (including DC) that will be required to implement work requirements and from focus groups with officials in eight states: Arizona, Indiana, Montana, Nebraska, Ohio, Pennsylvania, Virginia, and Washington.
A per capita cap in Medicaid may be a solution in search of a problem. However, if a cap substantially reduced federal Medicaid spending over time, it would put states at financial risk and force cuts to services and rates paid to physicians, hospitals, and nursing homes.
So far in 2025, ACA Marketplace enrollment has more than tripled since 2020 in at least 6 states: Texas, Mississippi, Georgia, Louisiana, West Virginia, and Tennessee. All of these states were won by President Trump.
Cutting funding for the trusted and impartial source of important information Navigators provide could have big impacts just as many consumers may need to re-evaluate their coverage options.
© 2026 KFF