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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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  • New Study Examines the Current Spending on Health Care for the Uninsured and Projects the Cost of Additional Medical Care if the Population Were Insured

    Report

    This study examines the current spending on care for the uninsured and projects additional medical spending if the population had health insurance coverage. The study finds that the uninsured will spend $30 billion out-of-pocket for health care in 2008 while receiving $56 billion in uncompensated care, three quarters of which will be from government sources. The study is an update of a previous Kaiser study and also projects the additional cost to the nation’s health…

  • Health Care Reform Newsmaker Series: Sen. Orrin Hatch

    Event Date:
    Event

    This May 7, 2009 webcast features Sen. Orrin Hatch (R-Utah), senior member of the Senate Committee on Finance, and ranking Republican on the panel’s Subcommittee on Health Care. The briefing was part of the Health Care Reform Newsmaker series sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an…

  • Health Care Reform Newsmaker Series: Sen. Chris Dodd

    Event Date:
    Event

    This webcast captures an April 28, 2009 briefing with Sen. Chris Dodd (D-Conn.), senior member of the U.S. Senate Committee on Health, Education, Labor and Pensions. The briefing was part of the Health Care Reform Newsmaker series sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader…

  • Real Industry Action on Health Reform?

    Other Post

    The Washington Post published an op-ed authored by Foundation President and CEO Drew Altman which examines how the health industry's voluntary commitment to curb health care spending is similar and different from past efforts. Read the Article

  • Testimony Related to Health Reform

    Event Date:
    Event

    The Kaiser Family Foundation is frequently invited to provide expert testimony before Congress on key health care issues. Testimony At NAIC Exchanges Subgroup Public HearingKaiser Family Foundation Vice President Gary Claxton, who directs the Foundation's Marketplace Policy Project, testified July 22, 2010, before the National Association of Insurance Commissioners' Exchanges (B) Subgroup established by the health reform law. Private Long-Term Care Insurance and the Challenge of Closing the Long-Term Care Funding GapAt a June 3…

  • Explaining Health Care Reform: Questions About Medicaid’s Role

    Issue Brief

    Medicaid plays a major role in covering more of the uninsured under the new health reform law. The new law includes a significant expansion of Medicaid, an individual requirement to obtain health insurance, and subsidies to help low-income individuals buy coverage through newly established Health Benefit Exchanges. This brief explains the how Medicaid works today and answers some key questions about Medicaid’s role in health reform. Issue Brief (.pdf)

  • How Will Uninsured Parents Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured parents and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Public Opinion on Health Reform: What Do the Polls Mean?

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation co-sponsored this briefing to have a panel of experts answer questions about how public support for health reform waxes and wanes depending, not only on what's being proposed in the reform proposals, but also on who asks the question and how it is asked. Issues addressed include: Do the majority of Americans support health care reform now? Do people want to pay for covering the…

  • Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

    Event Date:
    Event

    The Alliance for Health Reform and The Commonwealth Fund co-sponsored this briefing to explore the health reform proposals being considered which may impose responsibilities on both individuals and employers to have and help pay for coverage and whether they will be able to pay the amounts above the subsidies. Questions addressed include:If Congress exempts people from the coverage requirement or significantly reduces the penalties for noncompliance, will enough healthy individuals purchase new coverage to adequately…

  • Massachusetts Special Election Poll

    Poll Finding

    The Foundation, as part of The Washington Post/Kaiser Family Foundation/Harvard University partnership series, conducted a poll to better understand how health care played into the mix of issues and frustrations that brought voters to the polls in the Massachusetts special election for U.S. Senate. The poll was conducted among a random sample of 880 voters in the Massachusetts special election on January 19, 2010 and also interviewed were 242 Massachusetts adults who did not participate…