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The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

About the ACA

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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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  • Medicaid’s Role in Kentucky

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Kentucky. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Kentucky.

  • Data Note: Modestly Strong but Malleable Support for Single-Payer Health Care

    Feature

    The latest Kaiser Health Tracking poll finds that while there has been a modest increase in the public’s level of support for single-payer in recent years, a substantial share of the public remains opposed to such a plan, and opinions are quite malleable when presented with the types of arguments that would be likely to arise during a national debate.

  • Association Health Plans for Small Groups and Self-Employed Individuals under the Better Care Reconciliation Act

    Issue Brief

    A provision in the Senate Better Care Reconciliation Act (BCRA), a bill to repeal and replace the Affordable Care Act (ACA), would establish association health plan options for small employers and self-employed individuals. For these plans, the requirement that premiums cannot vary based on health status would not apply. This brief describes how association health plans could affect premiums in the small group and non-group markets.

  • Kaiser Health Tracking Poll – June 2017: Women’s Health

    Feature

    The Affordable Care Act (ACA) requires employers to cover the full cost of prescription birth control as part of their health insurance plans. The June Kaiser Health Tracking Poll finds that a majority of the public support the requirement for private health insurance plans to cover the full cost of birth control. This includes a majority of Democrats, independents, and Republicans.

  • The Republican Base is Getting Less Excited About Health Care

    From Drew Altman

    In this Axios column, Drew Altman explains that as Republican policymakers are focused on delivering a repeal of Obamacare for their base, polling shows that it’s not a top priority for Trump supporters, and their intensity on a replacement plan has declined, suggesting that the issue may not drive turnout for future elections.

  • ACA Replacement Plans and the Individual Market

    Feature

    This slideshow compares premiums and tax credits under proposed replacement plans for the Affordable Care Act, including the Senate's Better Care Reconciliation Act and the House-passed American Health Care Act.

  • Media Availability on Senate Health Bill

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call Tuesday, June 27, with key experts to explain the Senate Republican health bill and to answer questions about its implications and the CBO’s scoring of the bill. During the call, Kaiser's experts  answered reporters' questions about the bill’s potential impact and implications, including how premiums, tax credits, and insurer participation in the ACA’s marketplaces could change; how the bill would phase out federal funding for the…

  • Premiums under the Senate Better Care Reconciliation Act

    Issue Brief

    This analysis provides estimates of how premiums, after taking into account tax credits, would differ in 2020 under the Senate's Better Care Reconciliation Act (BCRA) vs. the Affordable Care Act (ACA) for people currently enrolled in the federal and state insurance marketplaces.