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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 New Health Care Agenda: Gridlock, Lots of Hearings

    From Drew Altman

    In an Axios column, Drew Altman analyzes what the midterm election means for the health policy agenda between now and 2020--mostly political positioning and gridlock in Congress, with most of the action affecting people in the states. 

  • What Does the Outcome of the Midterm Elections Mean for Medicaid Expansion?

    Fact Sheet

    While not typically an election issue, Medicaid — particularly the Medicaid expansion created under the Affordable Care Act (ACA) — was an important issue in the 2018 midterm elections in a number of campaigns throughout the country. This fact sheet highlights key states in which the results of the 2018 midterm elections have implications for Medicaid adoption or implementation. States examined include those that had Medicaid expansion ballot initiatives as well as states that have…

  • 2019 Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: esta calculadora refleja las primas para 2019. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • 2019 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2019 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • Short-Term Health Insurance Plans Charge Less than Half as Much in Premiums as ACA Plans By Excluding Pre-Existing Conditions and Severely Limiting Benefits

    News Release

    Short-term health insurance plans offer a trade-off for consumers: substantially lower premiums than plans that comply with the Affordable Care Act, but much less protection if they get sick and need care. Just how much cheaper are the premiums and what are consumers giving up to get them? A new KFF (Kaiser Family Foundation) analysis finds short-term plans are able to charge premiums 54 percent lower than ACA-compliant plans, by excluding pre-existing conditions and severely…

  • Web Briefing for Journalists: Key Issues Ahead of Marketplace Open Enrollment

    Event Date:
    Event

    Marketplace open enrollment, the period during which consumers can shop for health plans or renew existing coverage through the Affordable Care Act’s health insurance marketplaces, begins on Nov. 1. Recent policy changes at the state and federal levels have the potential to impact individuals and families purchasing health insurance for 2019. It’s the first open enrollment period following Congress’ repeal of the ACA’s individual mandate penalty, the requirement that individuals have minimum essential health coverage…

  • 2019 Premiums for ACA Silver Plans Will Be 16 Percent Higher Than They Would Have Been Absent the Repeal of the Individual Mandate, Expansion of Short-Term Plans and Loss of Federal Cost-Sharing Payments, Analysis Finds

    News Release

    Although 2019 premiums for plans in the Affordable Care Act marketplaces are flat or falling in many parts of the country, they would be substantially lower still if not for several Trump administration-backed changes to private insurance markets, finds a new KFF analysis. ACA silver-level plans sold in the marketplaces will cost an average of 16 percent more than they otherwise would have, thanks to the combined effects of the loss of ACA cost-sharing reduction…

  • How Repeal of the Individual Mandate and Expansion of Loosely Regulated Plans are Affecting 2019 Premiums

    Issue Brief

    In health insurance systems designed to protect people with pre-existing conditions and guarantee availability of coverage regardless of health status, countervailing measures are also needed to ensure people do not wait until they are sick to sign up for coverage (as doing so would drive up average costs for other enrollees). The Affordable Care Act (ACA) included a variety of “carrots” (e.g., premium tax credits and cost-sharing reductions) and “sticks” (e.g., the individual mandate penalty…