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The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Health Reform: Implications for Women’s Access to Coverage and Care

    Issue Brief

    This issue brief, Health Reform: Implications for Women's Access to Coverage and Care, reviews how the Affordable Care Act is expected to affect access to care and affordability of health coverage for women. It also explains the provisions in the health reform law related to preventive screening services, reproductive health, maternity care and women on Medicare. The brief includes national and state-level estimates of the percentage of uninsured women ages 18-64 who are likely to…

  • The Role of the Basic Health Program in the Coverage Continuum: Opportunities, Risks & Considerations for States

    Issue Brief

    This brief assesses the potential benefits and drawbacks to states from implementing a Basic Health Program under the Affordable Care Act. The law gives states the option of creating a Basic Health Program, using federal tax money to subsidize insurance coverage for low-income residents who would otherwise be eligible to purchase coverage through a state exchange. Such a program would give states the ability to provide more affordable coverage for these low-income residents and improve…

  • Pulling it Together: How the ACA Can Help The Homeless

    From Drew Altman

    Estimates are that there are approximately 630,000 people who are homeless on any given night in the U.S. -- about two-thirds in shelters and one-third on the street or without real shelter. Several million people are estimated to experience homelessness over the course of a year. About two-thirds are individuals and the balance are in families. These numbers are virtually identical to national estimates we used when I worked intensively on the issue of homelessness in the…

  • State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

    Report

    The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…

  • The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis

    Report

    A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have enormous consequences for health coverage for the low-income population. This analysis uses the Urban Institute’s Health Insurance Policy…

  • Trends in Employer-Sponsored Insurance Offer and Coverage Rates, 1999-2014

    Issue Brief

    This issue brief uses data from the National Health Interview Survey (NHIS) to examine trends in employer-sponsored health insurance (ESI) for different of individuals and households in the United States. While ESI remains the leading source of coverage for nonelderly people, the percentage covered by an employer plan has declined over the past 15 years. A similar pattern exists with firm offer rates; fewer workers were offered health insurance from their employer in 2014 than…

  • More Than Meets the Eye: Long-Term Care Provisions in the New Reform Law

    Event Date:
    Event

    In the debates around the health reform law and its implementation, little attention has been given to the law's provisions supporting long-term care. This briefing offered an overview of these provisions, such as the CLASS Act, a new national, voluntary insurance program to help working adults finance services and supports that they may need in the future, and the Community First Choice Option, which helps Medicaid recipients get attendant care at home. This October 1…

  • Florida’s Plan to Import Prescription Drugs from Canada, the First of its Kind, May Face Obstacles that Could Delay Implementation and Savings

    News Release

    A new KFF policy watch explains some of the hurdles the state of Florida still must clear before it can implement its novel plan to make some prescription drugs more affordable by importing them from Canada. Florida’s plan represents the first time the Food and Drug Administration (FDA) has granted authority for a state to safely import prescription drugs from another country. However, the state must take some additional steps to move forward with the…

  • ¿Tengo que renovar la cobertura de Medicaid cada año?

    FAQs

    Si. Los estados generalmente comienzan el proceso enviando un aviso a cada individuo. Tenga en cuenta que el proceso de renovación puede verse diferente dependiendo de dónde viva, por lo que debe consultar el sitio web de Medicaid de su estado para ver qué requiere su proceso de renovación. Haga clic aquí para obtener una lista de sitios web y números de teléfono de cada agencia estatal de Medicaid para conocer el proceso y los…

  • Estoy cubierto por Medicaid, pero me pregunto si puedo cancelar mi Medicaid y comprar uno de los planes de salud que se ofrecen a través del mercado de seguros?

    FAQs

    Si bien puede adquirir una cobertura del mercado de seguros, si actualmente tiene cobertura de Medicaid o le han informado que cumple los requisitos para recibirla, no podrá acceder a los subsidios para las primas que hacen que la cobertura sea más asequible para las personas con ingresos más bajos. Sin los créditos fiscales del mercado, el costo de un plan probablemente sea inasequible. Medicaid ofrece una cobertura integral sin primas o con primas bajas,…