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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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  • Behind the Challenges to Universal Health Coverage

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses why political reality and the diverse makeup of the remaining uninsured population mean that the likeliest path to universal coverage is a multi-step approach.

  • Key Data on Health and Health Coverage in South Carolina

    Fact Sheet

    This fact sheet draws on data from “Health and Health Coverage in the South: A Data Update” to highlight findings for South Carolina. The findings show the current status of health and health coverage in the state and the potential coverage gains that may be achieved through the Affordable Care Act.

  • Health and Health Coverage in the South: A Data Update

    Issue Brief

    This brief provides key data on the South and the current status of health and health coverage in the South to provide greater insight into the health needs in the region and the potential coverage gains that may be achieved through the ACA. It includes data on the uninsured, Medicaid expansion and eligibility for coverage.

  • What New Data Tell Us About Doctor Choice

    News Release

    Is choice of doctors eroding? Drew Altman explores the rhetoric versus reality and why the issue resonates with Americans, in his latest column for The Wall Street Journal's Think Tank. All previous columns by Drew Altman are online.

  • What New Data Tell Us About Doctor Choice

    From Drew Altman

    Drew Altman explores the rhetoric versus reality on whether choice of doctors is eroding and why the issue resonates with Americans, in this column for The Wall Street Journal's Think Tank.

  • Medicaid and Family Planning: Background and Implications of the ACA

    Issue Brief

    This brief reviews the role of Medicaid in financing and enabling access to family planning services for low-income women; discusses how states have expanded access to these services with Medicaid; and highlights future programmatic challenges in the context of the health care delivery and coverage reforms resulting from the Affordable Care Act (ACA).

  • The Affordable Care Act Doesn’t Rank Highly As an Issue for Voters in the Presidential Primaries

    News Release

    Despite Anecdotal Reports about Narrow Networks, 87% of Working-Age Adults with Insurance Are Satisfied With Their Plan's Choice of Doctors; 12% Say They Had to Change Doctors in Past Year As the ACA's Open Enrollment Nears End, Most of Those Who Remain Uninsured Are Disengaged While this month Congress passed and President Obama vetoed legislation to repeal the Affordable Care Act, voters nationally aren't focused on the law in this year's presidential election, the latest…