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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

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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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  • The Affordable Care Act After Six Years

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do. All previous Drew Altman columns are online.

  • Kaiser Health Tracking Poll: March 2016

    Feature

    The March Kaiser Health Tracking Poll finds that health care is one of many issues that will be important to voters in the Presidential election, trailing concerns about the economy and jobs but leading concerns about immigration. Health care ranks higher for Democratic voters than for Republican and independent voters and is a higher priority for women than for men. Health care costs remain on the forefront of the minds of both the uninsured and…

  • Is There a Health Care Vote? More for Democrats and Women than Other Groups

    News Release

    About One Third of Americans Perceive Wide-Scale Effort to Limit Women’s Reproductive Health Choices and Services; Most Who Do Say the Effort is a ‘Bad Thing’ Health care is one of many issues that will be important for voters in the presidential election, particularly for Democrats and women, finds the March Kaiser Health Tracking Poll. More than a third (36%) of voters consider health care “extremely important” to their vote in this year’s presidential election,…

  • 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…

  • Surprise Medical Bills

    Issue Brief

    This brief explores the problem of "surprise medical bills" -- charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.

  • How has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs

    Issue Brief

    To further understand how the first full year of Medicaid expansion has affected patients who are homeless and the providers who care for them, this analysis uses data from the Uniform Data System (UDS) for health centers to examine changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects serving the homeless population.

  • Assessing ACA Marketplace Enrollment

    Issue Brief

    This analysis examines factors that may have kept 2016 enrollment in Affordable Care Act (ACA) marketplace plans from reaching early projections, and it estimates that sign-ups will continue to grow modestly in coming years.

  • New Analysis Suggests ACA Marketplace Enrollment Could Grow Modestly Over Next Few Years, up to 16.3 Million Sign-Ups, 14.7 Million Enrollees after Attrition

    News Release

    A new analysis from the Kaiser Family Foundation finds that sign-ups in Affordable Care Act marketplace plans could continue to grow modestly over the next few years to 16.3 million (up 28%), based on the experience of the top-performing states. Assessing ACA Marketplace Enrollment examines factors that may have kept enrollment in 2016 from reaching early projections, including smaller declines than expected in employer coverage and a substantial number of people buying their own insurance…

  • Outreach and Enrollment Strategies for Reaching the Medicaid Eligible but Uninsured Population

    Issue Brief

    This brief identifies a range of successful strategies to reach and enroll Medicaid- and CHIP-eligible individuals as well as options to facilitate renewals. It draws on a collection of previous work examining state enrollment experiences after implementation of the ACA. In sum, it shows that states that have achieved enrollment success have embraced an array of strategies and approaches that include promoting the expansion through strong leadership and collaboration, implementing broad marketing and outreach campaigns,…