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

    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…

  • FAQs

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    FAQs: Health Insurance Marketplace and the ACA Find answers to frequently asked questions about buying coverage on the health insurance marketplaces. Preguntas frecuentes: mercado de seguros de salud y ACA En nuestras preguntas frecuentes podrá encontrar las respuestas a las preguntas más comunes sobre seguros médicos. This list of Frequently Asked Questions (FAQs) about the Medicare Open Enrollment period covers a range of topics related to enrollment, including Medicare Advantage, Part D, Medigap, and more.…

  • Key Facts about the Uninsured Population

    Issue Brief

    The number and share of people without insurance grew in 2024, increasing for the first time since 2019, according to KFF's analysis of data from the American Community Survey (ACS). This issue brief describes trends in health coverage in 2024, examines the characteristics of the uninsured population , and summarizes the access and financial implications of not having coverage.

  • Federal Medicaid Spending Through State Directed Payments Nears $100 Billion Annually Across 41 States, With New Limits Set to Reduce Funding to States  

    News Release

    Forty states and DC currently receive $93 billion in annual federal Medicaid spending through state directed payments (SDPs) and may be at risk due to forthcoming limits on these payments, according to new KFF estimates. Annual federal spending on SDPs is highest in California (an estimated $10.6 billion)—followed by Texas ($6.3 billion), North Carolina ($5.2 billion), and Illinois ($5.1 billion). 

  • State Health Coverage for Immigrants and Implications for Health Coverage and Care

    Issue Brief

    Noncitizen immigrants, particularly those who are undocumented, face significant barriers to accessing health coverage and care and are significantly more likely than citizens to be uninsured. This brief provides an overview of state health coverage programs for immigrants, including among states that have taken up options in Medicaid and the Children’s Health Insurance Program (CHIP) to expand coverage for lawfully present immigrants and/or established fully state-funded programs to fill gaps in coverage for immigrants.

  • What We Know So Far About 2026 ACA Marketplace Enrollment, Premiums, and Deductibles

    Issue Brief

    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 Marketplace Deductible Grew by About $1,000 Per Person in 2026, With More Enrollees Shifting to Higher-Deductible Plans as Enhanced Tax Credits Expired

    News Release

    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.