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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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  • Joe Biden’s Big Lead on Health Care Issues

    From Drew Altman

    In an Axios column, Drew Altman discusses how this election year health isn’t a single issue -- but several -- and Joe Biden has the edge over President Trump on all of them, even as opposition to the ACA remains popular with Trump’s base.  

  • What Happens to Medicaid Drug Policy if the ACA is Overturned?

    Issue Brief

    The repeal of the ACA could mean loss of Medicaid coverage for up to 15 million that were enrolled in the ACA Medicaid expansion group prior to the COVID-19 pandemic; however, repeal could also mean significant changes to Medicaid prescription drug policy with implications for state and federal spending for prescription drugs for non-expansion Medicaid enrollees.

  • Kaiser Health Policy News Index: December 2014

    Feature

    Other than the big stories of Ferguson, Ebola and ISIS, the only other news which captured a majority of the public’s attention this month was President Obama’s executive order on immigration. Smaller, yet substantial, shares report closely following many health policy news stories this month. Over four in ten say they closely followed the lawsuit filed by House Republicans against President Obama over the implementation of the health care law and about a third say…

  • Which Path for Health-Care Politics in 2015?

    News Release

    In his first 2015 column for The Wall Street Journal's Think Tank, Drew Altman explains why this year, status quo for the Affordable Care Act is not an option and how the Supreme Court rules in King v. Burwell will determine its path. All previous columns by Drew Altman are available online.

  • Visualizing Health Policy: Premium Changes in the Affordable Care Act’s Insurance Marketplaces 2014-2015

    News Release

    This Visualizing Health Policy infographic illustrates the change in monthly premiums by county, and select cities, from 2014 to 2015 for a 40-year-old person covered by the second-lowest-cost silver “benchmark” plan in the Affordable Care Act’s insurance marketplaces. Premium changes were greatest in Summit County, Colo. (45% decrease) and southeastern Alaska (34% increase), before tax credits. After accounting for tax credits, premiums for a 40-year-old person with an annual income of $30,000 would remain flat in…

  • Proposed Medicaid Expansion in Tennessee

    Fact Sheet

    This fact sheet describes Tennessee’s 1115 waiver demonstration project, Insure Tennessee, which expands the State’s Medicaid program under the Affordable Care Act.

  • As the Courts Weigh the Future of the ACA’s Preventive Services Coverage, a New Analysis Shows that Most People with Private Insurance Received At Least One of Those Benefits in 2018

    News Release

    The provision of the Affordable Care Act (ACA) that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in federal court. The U.S. District Court in the Northern District of Texas in September concluded that aspects of the requirement were unconstitutional and violated religious rights but has allowed the provision to remain in effect while it considers a remedy. As the courts consider the ACA’s…