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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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  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election.

  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election. All previous columns by Drew Altman are available online.

  • ACA Advertising in 2014 – Insurance and Political Ads

    Report

    This study analyzes the volume and content of political ads mentioning health care issues that aired in 2014 through Oct. 15, as well as health insurance spots promoting specific insurance products or encouraging enrollment in marketplace plans. It finds that about 14 percent of political ads in all races mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way.

  • New Analysis Finds the Affordable Care Act Mentioned in 14% of This Year’s Political Ads

    News Release

    Republican Ads Were Much More Likely to Mention ACA, Often in Spots that Also Hit Other Issues About 14 percent of political ads in all races airing this year through October 15 mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way, a new Kaiser Family Foundation study finds. Overall, about a quarter (26%) of political spots airing so far this year mention health care issues, including…

  • Data Note: Gearing Up For Round 2 of Open Enrollment: Some Lessons From Round 1

    Poll Finding

    As the second round of open enrollment approaches, policy makers, journalists, insurers and enrollment groups may want to keep in mind what health insurance shoppers told us about their experiences during the first open enrollment period. This data note examines selected findings from two Kaiser Family Foundation surveys that shed light on how people navigated the new options and choices available under the ACA during last fall’s open enrollment, with the hope of helping to…

  • Explaining the 2015 Open Enrollment Period

    Issue Brief

    The brief provides an overview of what consumers can expect during the second annual Open Enrollment period under the Affordable Care Act (ACA), which runs from November 15, 2014 through February 15, 2015. It is the second opportunity for uninsured individuals to enroll in private insurance coverage, premium tax credits and cost sharing subsidies and the first time that people newly insured in 2014 can renew their health plan coverage and subsidies. It also overlaps…

  • What to Expect From the Next Congress on the ACA

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explains how Republican control of Congress will likely bring challenges to the Affordable Care Act in two flavors.

  • Updated FAQs Provide New Answers as the Affordable Care Act’s Marketplace Enters Its Second Year

    News Release

    Today, the Kaiser Family Foundation released an updated collection of Frequently Asked Questions (FAQs) providing detailed answers for consumers, and the navigators and brokers who assist them, as the Nov. 15 start date nears for the Affordable Care Act's second open enrollment period. The searchable collection includes nearly 300 up-to-date responses, answering new questions about plan renewal, cancellations, and continuing financial assistance. The FAQs also offer guidance for understanding 2014 federal income taxes in the…

  • The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs

    Report

    The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015.…

  • Kaiser Calculator Now Gives Consumers 2015 Zip Code-Specific Premium and Tax Credit Estimates for Marketplace Coverage

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator now includes zip code-specific data on 2015 health plans that are being sold through the Affordable Care Act’s insurance marketplaces during the open enrollment period beginning Saturday, Nov. 15. With the new tool, consumers around the nation can generate estimates of their health insurance premiums and government subsidies for 2015 plans that they purchase on their own through an ACA marketplace. The estimates are based on zip…