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Affordable Care Act

The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "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 triple digits — with the expiration of enhanced tax credits."

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

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 triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Pulling it Together: A Primer on Health in the Election

    Perspective

    There is a lot of talk in polling and political circles and some speculation in the media about the role of health reform in the midterm elections. We regularly measure what the public thinks about health reform and you see reports from our monthly tracking polls about that. But whether those opinions will translate into an impact on people’s votes in the upcoming election is an entirely different question. First, to understand what might happen in…

  • With Federal Support, States Hold Steady in Medicaid and CHIP Coverage Policies for Low-Income Children and Families Despite Recession

    News Release

    New 50-State Survey Finds Some States Make Targeted Expansions to Strengthen Coverage and Achieve Efficiencies as They Prepare for Health Reform WASHINGTON -- Despite tight budgets, nearly all states maintained or made targeted expansions or improvements in their Medicaid and Children’s Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, preserving the programs’ ability to provide coverage to millions of low-income Americans who otherwise lack affordable options, according to a new survey released today…

  • Health Affairs Article: Medicaid Expansion: Chronically Homeless Adults Will Need Targeted Enrollment and Access to a Broad Range of Services

    Issue Brief

    Homeless adults may gain access to health services under the Affordable Care Act’s Medicaid expansion, which takes effect in 2014. This study, published in Health Affairs, analyzed the health coverage, health status, and health services use of 725 chronically homeless adults with disabilities in eleven cities in the United States.

  • Visualizing Health Policy: Premium Subsidy Scenarios Under Obamacare

    Other Post

    This month’s Visualizing Health Policy infographic shows 3 scenarios that illustrate the cost of health insurance under the Affordable Care Act for families in different circumstances, both before and after premium subsidies (in the form of a tax credit).

  • State Exchange Profiles: Alabama

    Other Post

    Final update made on December 4, 2012 (no further updates will be made) Establishing the Exchange Despite previously supporting Alabama’s implementation of a state-based health insurance exchange, Governor Robert Bentley (R) announced on November 13, 2012, the state will default to a federally-facilitated exchange.1 Prior to the decision, Governor Bentley issued Executive Order 17 which created the Alabama Health Insurance Exchange Study Commission to recommend how Alabama should establish a health insurance exchange.2 The Governor appointed…

  • Medicaid and Community Health Centers: The Relationship Between Coverage for Adults and Primary Care Capacity in Medically Underserved Communities

    Issue Brief

    Community health centers play an important role in providing care to uninsured and low-income individuals living in medically underserved communities. They rely on many different revenue sources and, over time, Medicaid has become a central source of funding for most health centers. To better understand how Medicaid influences health center practice, this paper compares the strength of health centers in states that have expanded Medicaid coverage for adults to health centers states with more limited…

  • Ensuring the Health Care Needs of Women: A Checklist for Health Exchanges

    Issue Brief

    To inform the development of the state health insurance Exchanges under the Affordable Care Act, this checklist identifies key coverage, affordability and access issues that are important for women. Based on lessons learned from women’s health research and the Massachusetts experience, the checklist considers essential health benefits, implementation of no-cost preventive services including contraception, provider networks and affordability, outreach and enrollment efforts, and the importance of including gender and other demographic characteristics in data collection…