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Affordable Care Act

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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  • The Health-Care Enrollment Story Is in the States

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the Department of Health and Human Services.

  • Obamacare and You: If You Have Medicare…

    Fact Sheet

    This short explainer highlights some of the key information for people with Medicare about how Affordable Care Act, also known as Obamacare, may affect them.

  • Obamacare Vital Signs Not Just Numbers

    From Drew Altman

    In his latest column, Kaiser President and CEO Drew Altman discusses the focus on first year metrics, especially enrollment projections, in the ACA debate.

  • Implications of the Affordable Care Act for People With HIV Infection and the Ryan White HIV/AIDS Program: What Does the Future Hold?

    Issue Brief

    There are numerous aspects of the Affordable Care Act that will be important for people with HIV in the U.S., -- however, it is unlikely that these changes will address all the needs of people with HIV. The Ryan White HIV/AIDS Program will thus remain crucial for the provision of adequate health care to HIV-infected individuals, but it will need to change. Changes in the Ryan White Program’s role will depend largely on state decisions…

  • Obamacare y Usted: Si no tiene seguro médico

    Fact Sheet

    Obamacare ha creado nuevas maneras de tener cobertura de salud. Si usted no tiene seguro médico a través de su empleador, seguramente pueda obtenerlo a través del nuevo Mercado de los Seguros Médicos (o "intercambio") en su estado. Nuevas opciones de cobertura Llenando una única aplicación, usted aprenderá sobre sus opciones de planes médicos y los costos, y si califica para tener cobertura a través de Medicaid o para recibir un subsidio para comprar un…

  • Obamacare y Usted: Si tiene una condición preexistente

    Fact Sheet

    Si usted o alguien de su familia tiene una condición de salud preexistente - como una enfermedad cardíaca, asma o inclusive un embarazo - usted encontrará que es mucho más fácil obtener cobertura o cambiar de plan, comenzando en el 2014. Obamacare prohíbe a las aseguradoras negar cobertura a personas con condiciones preexistentes, o condiciones físicas o mentales que existan antes que haya comenzado la cobertura. Las aseguradoras tampoco pueden negarse a pagar por otro…

  • JAMA Forum: Why the Ruckus Over the Cadillac Plan Tax?

    Perspective

    Larry Levitt’s October 2015 post explains the terms of the much-debated Cadillac plan tax, how it is designed to reduce health costs, and how it could end up shifting more costs to workers.