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Individual Market Enrollment Declined by 18% Since June 2025

Individual Market Enrollment Fell 18%, Suggesting Continued ACA Marketplace Losses

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.

About the ACA

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Did the Affordable Care Act Make Health Care More Affordable?

The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees. KFF’s Cynthia Cox examines the ACA’s record and the broader underlying question it raises: what’s a fair price for Americans people to pay for health care?

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  • Poll: Most Americans Don’t Realize How Dramatically the Medicare-for-all Proposals Would Revamp the Nation’s Health Care System

    News Release

    As Congress and the Democratic presidential candidates continue to discuss Medicare-for-all and other proposals to expand public health coverage, most Americans know little about how the leading Medicare-for-all proposals would reshape the way all Americans get and pay for health care. This month’s KFF Health Tracking Poll probes the public’s awareness of key elements of proposals to create a national health plan, including the leading Medicare-for-all bills introduced by Sen. Bernie Sanders and Rep. Pramila…

  • Visualizing Health Policy: Barriers to Care Experienced by Women in the United States 

    News Release

    This Visualizing Health Policy infographic looks at barriers to care experienced by women in the United States. Women incur greater health care costs than men, particularly during the reproductive years. Despite a lower uninsured rate than men (11% vs 14%), women are more likely to skip a recommended medical test or treatment due to cost. However, cost barriers to contraception have decreased for insured women since the Affordable Care Act’s (ACA’s) coverage requirement took effect.…

  • Voters Are Tuning Out the Health Care Debates

    From Drew Altman

    In this Axios column, Drew Altman reports on new KFF focus groups with voters. They show voters are focused on the problems they have paying for care and navigating the health system, but have yet to tune in on the health proposals being made by candidates and elected officials, and don’t see them as relevant to their problems. 

  • JAMA Forum: Medicare-For-All or Medicare-For-More?

    Perspective

    In this May 2019 post for The JAMA forum, Larry Levitt examines how the early discussion and positioning among the presidential candidates offers a glimpse into how a debate about Medicare-for-all might play out.

  • Individual Market Insurers Are Expecting to Pay a Record $800 Million in Rebates to Consumers for Excessive Premiums in 2018

    News Release

    Individual market insurers are expecting to return to consumers a record total of about $800 million in excess premiums for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date, finds a new KFF analysis. The rebates to more than 3 million eligible individual market consumers, based on preliminary estimates by insurers, must be issued by September 30. They are the result of the…

  • The Silent Affordability Crisis Facing Sick People

    From Drew Altman

    In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

  • Individual Insurance Market Performance in 2018

    Issue Brief

    Individual market insurers are expecting to return to consumers a record total of about $800 million in medical loss ratio rebates for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date. Financial results for 2018 suggest that insurers in the individual market are generally returning to or exceeding profitability levels seen before 2014, when ACA insurance market rules took effect, including the requirement…