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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 ACA and People with HIV: Profiles from the Field

    Issue Brief

    This brief provides profiles of twelve individuals living with HIV to offer an in-depth look at how the Affordable Care Act (ACA) has affected their healthcare and coverage. Participants live in California, Florida, Georgia, New York, and Texas and discuss their enrollment and coverage experience, including whether they got new coverage (in the Marketplace or Medicaid), how their HIV care has been affected, and the role of the Ryan White HIV/AIDS Program.

  • New Evidence Health Spending Is Growing Faster Again

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Census Department survey data showing higher health spending growth over the last four economic quarters, and raises the question: is the health spending slowdown over?

  • Poll Finds Nearly Three Quarters of Americans Say Prescription Drug Costs Are Unreasonable, and Most Blame Drug Makers Rather Than Insurers for the Problem

    News Release

    If Supreme Court's King v. Burwell Decision Restricts Insurance Subsidies to Certain States, Most Say Congress Should Act to Ensure Residents of All States are Eligible, and a Majority in Potentially Affected States say Their State Should Act Public's Views on Affordable Care Act Are Divided and Unchanged: 42% Unfavorable and 39% Favorable Nearly three quarters (73%) of the public view prescription drug costs as unreasonable, and far more blame pharmaceutical companies more than insurers…

  • Media Availability on the U.S. Supreme Court’s King v. Burwell Decision

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call with key experts on the Affordable Care Act (ACA), state marketplaces and more to explain the U.S. Supreme Court's decision in the King v. Burwell case and to answer questions about its implications. The petitioners in the case are challenging the legality of premium and cost-sharing subsidies for low- and middle-income people buying health plans in 34 states where the federal government rather than the state…

  • After King v. Burwell Ruling, Health Law Issues Involve Implementation

    News Release

    After today’s Supreme Court ruling upholding the Affordable Care Act’s federal subsidies, Drew Altman's latest column in The Wall Street Journal's Think Tank explores what the decision means and what’s next for the health law. All previous columns by Drew Altman are available.

  • Round 3: Legal Challenges to Contraceptive Coverage at SCOTUS

    Issue Brief

    This brief explains how the new regulations issued by the Trump Administration would change the contraceptive coverage requirement for employers and affect women’s coverage, the legal positions for challenging and defending these regulations, the potential rulings, and the broader ramifications.

  • Nearly 54 Million Americans Have Pre-Existing Conditions That Would Make Them Uninsurable in the Individual Market without the ACA

    News Release

    Almost Half of Non-Elderly Families have At Least One Adult with a Pre-Existing Condition An updated KFF analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. The share of adults under 65 with such declinable pre-existing conditions varies significantly across states, from at least…

  • Voters Aren’t Buying Trump’s Promises of a Health Care Plan

    From Drew Altman

    Drew Altman showcases new KFF polling on the public’s views of President Trump’s promise that he will have a “phenomenal” health care plan and protect Medicare, and analyzes what it means for health care politics.

  • 300+ FAQs Help Consumers Understand the ACA Marketplaces as Open Enrollment Begins

    News Release

    Ahead of the annual Affordable Care Act (ACA) open enrollment period, the time during which consumers can shop for health plans or renew existing coverage, KFF has updated and expanded its searchable collection of more than 300 Frequently Asked Questions about open enrollment, the health insurance marketplaces and the ACA. Designed to help consumers and the navigators, brokers and others who assist them, the FAQs cover a wide range of topics including eligibility for subsidies,…