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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  • Poll: Two-thirds of Voters Say a Candidate’s Position on Pre-existing Conditions is Important to their Vote, More than Say the Same about Drug Costs, ACA Repeal or Medicare-for-All

    News Release

    About two-thirds (65%) of voters say a candidate’s support for continued protections for people with pre-existing health conditions is either the “single most important factor” or “very important” to their vote in the upcoming midterms elections, finds the latest Kaiser Family Foundation tracking poll. That’s a larger share than says the same about other health care issues, including bringing down prescription drug costs (58%), repealing the Affordable Care Act (53%), stabilizing the ACA marketplaces (52%), or…

  • Most People Enrolled in Marketplace Coverage are Satisfied with Plan’s Premiums, Cost-Sharing and Provider Networks, New Survey Finds

    News Release

      Affordability Remains Significant Concern for Many in Non-Group Plans Following the Affordable Care Act's second open enrollment period, most people enrolled in marketplace plans report being satisfied with a wide range of their plan's coverage and features, finds a new Kaiser Family Foundation survey of people who buy their own health insurance. A large majority (74%) of those in marketplace plans rate their coverage as excellent or good, the survey finds. Most (59%) also…

  • Newly Insured Californians Report Easier Access to Care Than the Uninsured

    News Release

    Low-income California adults who gained insurance coverage in 2014 had an easier time accessing health care than those who were uninsured and increased financial protection from medical bills, according to a new Kaiser Family Foundation (KFF) report. The report, funded by the Blue Shield of California Foundation and based on findings from the California sample of the 2014 Kaiser Survey of Low-Income Americans and the ACA, finds that newly-insured Californians were more likely to have…

  • Workplace Wellness Programs Characteristics and Requirements

    Issue Brief

    This issue brief summarizes what’s known about workplace wellness programs offered by employers today and the use of financial incentives to encourage workers to participate. Findings are drawn from the KFF/HRET Annual Employer Health Benefits Survey. In addition, the brief reviews proposed changes by the Equal Employment Opportunity Commission (EEOC) in federal standards governing financial incentives by workplace wellness programs and how these changes might balance the use of incentives against other discrimination and privacy…

  • ACA Preventive Services at the Supreme Court

    Quick Insights

    If the Court rules in favor of Braidwood, private health insurers would no longer be required to cover, without cost sharing, certain preventive services recommended by USPTF after 2010 when the ACA was enacted.

  • A 90% Cut to the ACA Navigator Program

    Quick Insights

    Cutting funding for the trusted and impartial source of important information Navigators provide could have big impacts just as many consumers may need to re-evaluate their coverage options.

  • What is a grandfathered plan? How do I know if I have one?

    FAQs

    Grandfathered plans are those that were in existence on March 23, 2010, and have stayed basically the same. Grandfathered plans are not required to provide all of the benefits and consumer protections required by the Affordable Care Act. For example, a grandfathered plan might not cover preventive health services, it might charge higher premiums based on health status or gender, and it might exclude coverage for pre-existing conditions. If you buy coverage on your own and you…