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The ACA MarketplaceS

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: Most Democrats Prefer a Presidential Candidate Who Wants to Build on the Affordable Care Act

    News Release

    The latest KFF Health Tracking Poll probes Democrats’ views about the general approaches to expanding health coverage and lowering costs put forward by the candidates. Most Democrats and Democratic-leaning independents (55%) say they prefer a candidate who would build on the Affordable Care Act to achieve those goals. Fewer (40%) prefer a candidate who would replace the ACA with a Medicare-for-all plan. Even among those who prefer a candidate who would replace the ACA with…

  • Poll: Most Americans Say HIV Is Serious Issue for the Country as Trump Administration Rolls Out New Plan to End HIV by 2030; Black and Hispanic Adults Report More Personal Concern than White Adults

    News Release

    Support for Medicare-for-all Holds Steady With the Trump administration launching a new domestic HIV effort, the latest KFF Health Tracking Poll finds a large majority of Americans (80%) view the HIV epidemic as a serious national issue, including a third (34%) who view it as “very serious.” Nearly half (46%) view it as a serious concern for people they know, including a quarter (24%) who view it as “very serious.” The poll is the first to…

  • Individual Insurance Market Performance in 2018

    Issue Brief

    Individual market insurers are expecting to return to consumers a record total of about $800 million in medical loss ratio rebates for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date. Financial results for 2018 suggest that insurers in the individual market are generally returning to or exceeding profitability levels seen before 2014, when ACA insurance market rules took effect, including the requirement…

  • The Silent Affordability Crisis Facing Sick People

    From Drew Altman

    In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

  • Kaiser Health Tracking Poll: February 2014

    Feature

    The February 2014 Kaiser Health Tracking Poll finds that those who are most likely to be customers in the Affordable Care Act (ACA)’s new insurance exchanges (the uninsured and those who purchase their own coverage) are more likely to prefer less costly plans with narrow provider networks over more expensive plans with broader networks, while the public overall has the opposite preference. Overall opinion of the ACA remains about the same as it has been…

  • Sizing Up Exchange Market Competition

    Issue Brief

    This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and…