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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

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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  • How Affordable Care Act Repeal and Replace Plans Might Shift Health Insurance Tax Credits

    Issue Brief

    The Affordable Care Act, also known as Obamacare, and leading replacement proposals rely on refundable tax credits to help individual market enrollees pay for premiums, although the credit amounts are set quite differently. This analysis compares estimates of an average 2020 tax credit amount under the ACA with averages under the House Republicans' American Health Care Act, introduced March 6, 2017.

  • The American Health Care Act: New House GOP Bill Summary and Interactive Maps of Its Effects on Tax Credits

    News Release

    The Kaiser Family Foundation today issued a summary of the Republican House leadership’s March 6 proposed Affordable Care Act (ACA) replacement bill, the American Health Care Act, that can be compared in 17 key policy areas to the ACA and several other proposed replacement plans. In addition, the Foundation updated its interactive maps that compare county-level estimates of premium tax credits consumers would receive under the Affordable Care Act (ACA) in 2020 with what they’d receive…

  • Poll: Early Perceptions of House Bill Show Public Thinks It Would Cover Fewer People and Raise Health Costs

    News Release

    Republicans More Likely to Expect Positive Changes Than Democrats or Independents Large Majority Favors Continued Medicaid Funding to Planned Parenthood Fielded March 6-12 as Americans were first learning about the American Health Care Act and before the Congressional Budget Office estimated its effects, the latest Kaiser Tracking Poll shows that large shares of the public expect the House Republican health care plan would result in fewer people having health insurance and higher costs for people…

  • Who Are the 7 Million Nonelderly Adults with Disabilities in Medicaid and What Would the House GOP Bill to Restructure Medicaid Financing and Repeal the Affordable Care Act Mean for Them?

    News Release

    A new brief from the Kaiser Family Foundation explains the role that Medicaid plays for nearly 7 million nonelderly adults with disabilities in the U.S. and explores what the American Health Care Act could mean for their health care and coverage. Medicaid covers more than three in 10 nonelderly adults with disabilities, including people with physical disabilities, such as cerebral palsy, multiple sclerosis, and traumatic brain or spinal cord injuries; intellectual or developmental disabilities such…

  • U.S. Public Opinion on Health Care Reform, 2017

    Feature

    This slideshow supports a Visualizing Health Policy infographic with JAMA, spotlighting public opinion on health reform in the United States as of 2017, including priorities and views of the Affordable Care Act (also known as Obamacare) and its provisions.

  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

  • What New Data Tell Us About Doctor Choice

    From Drew Altman

    Drew Altman explores the rhetoric versus reality on whether choice of doctors is eroding and why the issue resonates with Americans, in this column for The Wall Street Journal's Think Tank.

  • Short-Term Limited Duration Plans and HIV

    Issue Brief

    Given the Trump Administration’s promotion of short-term limited-duration (STLD) health insurance policies, this brief examines what they mean for people with HIV. The analysis assesses whether people with HIV could enroll in STLD plans by applying to 38 plans across five states and getting in each case. It also assesses whether such plans could meet basic HIV care and treatment needs for someone diagnosed once enrolled. This finding takes on new importance in light of…