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The ACA MarketplaceS

What We Know about Trump’s $500 ACA Checks and the User Fees Funding Them

This analysis examines the $500 checks that the Trump administration is sending to some Affordable Care Act Marketplace enrollees and the user fees that are paying for them. The checks are going to about 1 million enrollees in the 30 states that rely on the federal HealthCare.gov Marketplace who are not receiving any tax credits this year.

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. The enrollment decline coincides with the expiration of the enhanced premium tax credits and other policy changes that are expected to reduce enrollment.

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • The Public and the Health Care Delivery System — Summary and Chartpack

    Poll Finding

    This summary and chartpack of the results of a survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlight the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts –- including electronic medical records, coordination of care and comparative effectiveness –- all of which have become serious components…

  • April 2009 Health Tracking Poll

    Poll Finding

    The April Kaiser Health Tracking Poll finds that six in ten Americans continues to say that they or a member of their household have delayed or skipped health care in the past year. A solid majority of the public believes health care reform is more important than ever because of current economic problems. The country’s overall economic problems have not dampened their interest in pursuing health care reform: a solid majority of the public (59%)…

  • Health Insurance Market Reforms: Rate Restrictions

    Fact Sheet

    Rate restrictions limit how much insurance companies can vary premiums charged to individuals and businesses based on factors such as health status, age, tobacco use and gender. Currently, federal law does not place any limits on the ways that insurance companies set their premium rates. However, beginning January 1, 2014, insurance companies must meet the Affordable Care Act's minimum premium rating rules for health plans for individuals and small businesses. This brief explains the current…

  • Implementing the ACA’s Medicaid-Related Health Reform Provisions After the Supreme Court’s Decision

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). A majority of the Court also found the ACA’s Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied by limiting the Health and Human Services (HHS) Secretary’s enforcement authority. The practical effect of the Court's decision makes the Medicaid expansion optional for states. This brief addresses questions…

  • Coverage of Preventive Services for Adults in Medicaid

    Issue Brief

    This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to cover such services for adults. The Affordable Care Act (ACA) provides states the opportunity to earn a one percentage point increase in their federal matching…

  • Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

    Fact Sheet

    This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and the demonstrations in each state are set to begin in April 2013. Fact Sheet (.pdf)

  • Key Findings: Kaiser Health Tracking Poll — July 2009

    Poll Finding

    This document contains the key findings from the July Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted July 7 through July 14, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (800) and cell phone (405, including 126 who had no landline telephone) were carried out in English and Spanish. The margin…

  • How Will Uninsured Children Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured children and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Matching Health Benefit Packages to Health Needs: Key Issues To Consider In Health Reform

    Event Date:
    Event

    Three reports and a video collectively examine the range of health care needs and costs that people face today against the backdrop of the scope of health coverage that may be available to them under health reform. Children and Health Care Reform: Assuring Coverage That Meets Their Health Care Needs and Individuals With Special Needs and Health Reform: Adequacy of Health Insurance Coverage examine the needs of children and adults, respectively, focusing on those with…

  • Key Findings: Kaiser Health Tracking Poll — September 2009

    Poll Finding

    This document contains the key findings from the September Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted September 11 through September 18, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 147 who had no landline telephone) were carried out in English and Spanish. The margin…