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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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  • Few Uninsured Know Date of Pending Deadline for Obtaining Marketplace Coverage; Many Say They Will Get Coverage Soon, Though Cost is a Concern

    News Release

    Most Democrats Like Medicare-for-All, But Very Few Say the Issue Will Drive Their Votes in the 2016 Elections Similar to Last Month, More Hold Unfavorable Views of the ACA than Favorable Ones The Affordable Care Act's third open enrollment period will end on Jan. 31, but the latest Kaiser Health Tracking Poll finds that only a small share of people without health insurance realize it. Just 7 percent of the uninsured correctly identify January as…

  • States with Section 1115 ACA Expansion Waivers, December 2015

    Feature

    This slide shows the current status of state decisions to use Section 1115 waivers to expand Medicaid. A total of 31 states including DC have adopted the ACA Medicaid expansion, including 6 states with ACA 1115 ACA expansion waivers. AZ has a pending waiver application that seeks changes to its expansion. MT and NH’s waivers will take effect on 1/1/16. PA originally expanded through a waiver but subsequently transitioned to a state plan amendment. TN…

  • Medicaid Expansion Spending and Enrollment in Context: An Early Look at CMS Claims Data for 2014

    Issue Brief

    This issue brief analyzes spending and enrollment data made available by CMS through the MBES. It breaks out spending and enrollment for the new adult group (Group VIII) that gained coverage in states that adopted the ACA Medicaid expansion. It looks at spending and enrollment for the new adult group in calendar year 2014, putting such data in the context of overall Medicaid spending and enrollment and examines trends across expansion states.

  • Health Insurance Marketplace Calculator Updated for 2016

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator is now updated to include local data on 2016 health plans that are being sold through the Affordable Care Act marketplaces. The Spanish-language version of the calculator is also updated.

  • A Guide to Understanding Medicaid Expansion Waivers as States Debate What to Do Under the ACA

    News Release

    With the recent governors’ elections in Kentucky and Louisiana refocusing attention on state Medicaid expansion decisions, a newly updated issue brief from the Kaiser Family Foundation provides an overview of the waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana -- that are pursuing alternative Medicaid expansions under the Affordable Care Act.

  • Covering the Remaining Uninsured: Not Just a Red-State Issue

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why covering the nation’s remaining uninsured population is more than just a red state issue. All previous columns by Drew Altman are available online.  

  • Two Substantive Sides to Debate Over Obamacare’s ‘Cadillac Tax’

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman says the debate about whether to keep or repeal the Cadillac tax is more than a debate between sound policy and good politics, there are strong substantive arguments on both sides. All previous columns by Drew Altman are available online.

  • The Affordable Care Act Doesn’t Rank Highly As an Issue for Voters in the Presidential Primaries

    News Release

    Despite Anecdotal Reports about Narrow Networks, 87% of Working-Age Adults with Insurance Are Satisfied With Their Plan's Choice of Doctors; 12% Say They Had to Change Doctors in Past Year As the ACA's Open Enrollment Nears End, Most of Those Who Remain Uninsured Are Disengaged While this month Congress passed and President Obama vetoed legislation to repeal the Affordable Care Act, voters nationally aren't focused on the law in this year's presidential election, the latest…