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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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  • Kaiser Health Tracking Poll: September 2015

    Feature

    As the Centers for Medicare & Medicaid Services prepares to finalize a plan to pay physicians for discussing end-of-life treatment options with Medicare patients, this month’s Kaiser Health Tracking Poll finds that about 8 in 10 of the public favors Medicare and private insurance covering such discussions and about 9 in 10 say doctors should have these discussions with their patients. However, relatively few (17 percent) say they’ve had such discussions with a doctor or other…

  • Public Strongly Favors End-of-Life Conversations Between Doctors and Patients, With About Eight in 10 Saying Medicare and Other Insurers Should Cover These Visits

    News Release

    Six in 10 Oppose 'Cadillac Plan Tax' on High-Cost Health Plans Set to Take Effect in 2018, But Cost Savings Argument Can Change Some Opinions Views on the Affordable Care Act Remain Divided: 45% Unfavorable, 41% Favorable As the Centers for Medicare & Medicaid Services prepares to finalize a plan to pay physicians for discussing end-of-life treatment options with Medicare patients, the latest Kaiser Health Tracking Poll finds an overwhelming majority supports such coverage. The…

  • Employer Family Health Premiums Rise 4 Percent to $17,545 in 2015, Extending a Decade-Long Trend of Relatively Moderate Increases

    News Release

    Since 2010, Deductibles for All Workers Have Risen Almost Three Times as Fast as Premiums and About Seven Times as Fast as Wages and Inflation Facing New Requirements, Few Employers Make Changes to Workers' Hours Menlo Park, Calif. – Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2015 Employer Health Benefits…

  • How Primary-Care Physicians Are Handling the Influx of Newly Insured

    News Release

    In his column for The Wall Street Journal's Think Tank, Kaiser’s President Drew Altman is joined by The Commonwealth Fund's President David Blumenthal to discuss the impact of the Affordable Care Act’s coverage expansion on the primary care delivery system. Their analysis is based on the Kaiser-Commonwealth National Survey of Primary Care Providers. All previous columns by Drew Altman are available online.  

  • How Primary-Care Physicians Are Handling the Influx of Newly Insured

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Kaiser’s President Drew Altman is joined by The Commonwealth Fund's President David Blumenthal to discuss the impact of the Affordable Care Act’s coverage expansion on the primary care delivery system.

  • New Analysis Shows States with Medicaid Expansion Experienced Declines in Uninsured Hospital Discharges

    Issue Brief

    Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on hospital payer mix across the country. Similar to other reports recently released, new data examining hospital discharges in 16 states with data through the second quarter in 2014 show increases in Medicaid and declines in uninsured or self-pay discharges in states that implemented the Medicaid expansion. These trends hold true for all hospital discharges as well as for specific…

  • New Tracker Monitors Affordable Care Act Preventive Services Coverage

    News Release

    The Affordable Care Act requires private insurance plans to cover recommended preventive services with no out-of-pocket charges for patients. This slate of covered services can change when the U.S. Preventive Services Task Force and other authorized groups add or modify recommendations; the federal government also periodically issues clarifications to guide health plans in their coverage. A new tracker from the Kaiser Family Foundation monitors the preventive services that must be covered for adults without cost sharing,…

  • The California Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and the health care delivery system in California in the era of health reform.