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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.
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Major federal changes to Medicaid eligibility and financing from the 2025 reconciliation law are coming, including new work requirements that will affect millions of Medicaid enrollees. KFF’s fact sheet provides an overview of what has changed, what is still ahead, and what the public thinks about Medicaid heading into the midterms.
Enrollment in the individual health insurance market fell by 18%—over 4.6 million people—from 25.2 million in June 2025 to 20.5 million in June 2026. Falling individual market enrollment suggests further decline in ACA Marketplace enrollment this year, since Marketplace enrollees represent the vast majority of individual market coverage.
KFF’s new interactive maps illustrate ACA Marketplace enrollment and changes in enrollment by congressional district and state. Marketplace enrollment declined in most congressional districts between 2025 and 2026, with two-thirds of the decline (67%) occurring in Republican-held congressional districts.
This interactive tracks announced insurer exits from and entries into the ACA Marketplaces for 2027.
More people than ever got coverage through the Affordable Care Act (ACA) Marketplaces in 2025, but the expiration of enhanced premium tax credits has driven up what people pay and contributed to declining enrollment in 2026. Law and regulatory changes also tightened ACA eligibility and enrollment requirements. Public opinion of the ACA remains generally favorable, although views remain divided along partisan lines.
This brief reports on rural and urban health center patients and financing in 2025 using national data from the Uniform Data System (UDS) and examines potential impacts of recent federal policy changes.
This analysis of available 2025 prior authorization data finds insurers denied at least 1 in 8 standard requests for prior authorization across three insurance markets: Medicare Advantage, Medicaid managed care, and the federally facilitated ACA Marketplaces. Denial rates varied wide segments by insurer. The analysis highlights limitations of the data and challenges for consumers interpreting it.
In a new column, Dr. Drew Altman, KFF's Founding President and CEO, discusses how New Mexico made childcare universal and became the only state to fully replace lost enhanced ACA tax credits while its leaders avoided polarizing labels like “progressive or “socialist.”
ACA Marketplaces insurers are proposing a median premium increase of 15% in 2027, according to KFF's updated analysis of 276 insurers with publicly available filings across all 50 states and the District of Columbia.
Following several years of rapid enrollment growth in the Affordable Care Act (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 ACA Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the expiring federal enhanced tax credits, generally…
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