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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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  • Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act

    Issue Brief

    The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research, this brief identifies five key lessons learned through previous Medicaid and CHIP experience to help inform outreach and enrollment under the ACA. The brief is…

  • Medicaid Expansion Through Marketplace Premium Assistance

    Fact Sheet

    This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

  • Obamacare and You: If You Are Uninsured…

    Fact Sheet

    The Affordable Care Act, also called Obamacare, creates several new ways to get health coverage. This fact sheet explains how If you are uninsured and not offered health coverage through your job, you may be able to obtain coverage through Medicaid or through a new health insurance marketplace (or exchange) in your state. It is from our Obamacare & You series.

  • Obamacare and You

    Fact Sheet

    Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people. Click on the links below to learn more: If You Are Uninsured  Haga clic para leer en español  If You Are Low-Income and May Qualify for Medicaid  Haga clic para leer en español If You Have a Pre-Existing Condition Haga clic para leer en español If You Buy Coverage in the Individual Market…

  • Where are California’s Uninsured Now? Wave 2 of the Kaiser Family Foundation California Longitudinal Panel Survey

    Report

    This second wave of the Kaiser Family Foundation's California uninsured survey assesses the impact of the Affordable Care Act to date on state residents who were uninsured prior to open enrollment. The results capture the share of previously uninsured Californians who gained coverage or remained uninsured, how they feel about and interact with their new coverage options and what barriers to getting insurance remain. The report examines breakouts by race, coverage type, and other demographic…

  • Helping People With HIV Navigate the Transition to ACA Coverage: Summary of a Roundtable Discussion

    Issue Brief

    In March 2013, the Kaiser Family Foundation convened key HIV/AIDS stakeholders from a variety of backgrounds to explore opportunities for maximizing the beneficial impact of the Affordable Care Act (ACA) for people living with HIV and examine strategies to help them navigate the transition to new health coverage. This report summarizes the information shared and key issues discussed at the meeting.

  • How the Midterms Factor Into Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how Democratic victories in several close gubernatorial races on Tuesday could revive efforts to expand Medicaid.

  • Web Briefing for Journalists: Consumer Issues Ahead of the Affordable Care Act’s Second Open Enrollment Season

    Event Date:
    Event

    The Affordable Care Act's second annual open enrollment period starts Nov. 15 and runs until Feb. 15 -- a three-month window for Americans to shop for and purchase new health coverage, or change their plan through Healthcare.gov or their state-run insurance marketplace.  This year's open enrollment season poses both new and recurring challenges for consumers:  How are premiums for marketplace plans changing, and what do the changes mean for consumers?  Why might current marketplace customers…