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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

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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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  • I notice something called “Easy pricing” under the plan name on HealthCare.gov. What does that mean?

    FAQs

    "Easy pricing" refers to a "standardized" plan design on HealthCare.gov that aims to make it simpler to compare plans by applying the same to each category of essential health benefits across all easy pricing plans in the same metal level. For example, all Bronze-level easy pricing plans have the same deductible and copays. By contrast, non-standardized Bronze-level plans might have different deductible and copay amounts. Easy pricing plans are marked with a green circle with…

  • I hear there is a special enrollment opportunity for people with very low income. How does that work?

    FAQs

    Starting August 25, 2025, the special enrollment opportunity that allowed individuals with incomes at or below 150% of the federal poverty level to sign up for Marketplace coverage year-round --simply due to their low income --was eliminated. Individuals at this income level might still qualify for special enrollment under other special enrollment events, such as when they lose coverage due to job loss or lose Medicaid coverage.

  • Do I have to renew Medicaid coverage every year?

    FAQs

    Yes. States must redetermine Medicaid eligibility for most enrollees every 12 months. When your coverage period is ending, you will receive a notice from the state. If your coverage has been automatically renewed, the notice will indicate the new coverage period. If your coverage has not been automatically renewed, the notice will include instructions for completing the renewal process. Note that the renewal process might look different depending on where you live. Click here for a…

  • How long after I enroll in a plan will coverage take effect?

    FAQs

    During Open Enrollment in HealthCare.gov and some other states, if you enroll in a private health insurance plan by December 15 and make your first premium payment by the due date specified by your plan, your new health coverage will start January 1. If you sign up after December 15, your coverage will begin on February 1. If you sign up for a Marketplace plan during a special enrollment period, your coverage will usually take…

  • I received a Form 1095-A from the Marketplace. What is that?

    FAQs

    Form 1095-A gives you information about the amount of advance premium tax credit (APTC) you received during the previous year. A copy of this form is also reported to the IRS. Keep this form with your other tax records. The APTC you received was based on the annual income you estimated you would earn when you signed up for Marketplace coverage. Now you must file a federal income tax return to compute your actual income for that coverage…

  • I had a Marketplace plan last year, but paid the full premium myself because I made too much to qualify for premium tax credits. When I did my taxes though, my income for the year ended up being less th...

    FAQs

    Yes. Premium tax credits can be claimed in advance (during the year) or when you file your taxes. To claim the credit, you will need to file a federal income tax return and Form 8962. Follow the instructions on Form 8962 to determine the amount of tax credit you should receive as a refund when you file your taxes.

  • What is Form 8962?

    FAQs

    If you received an advanced premium tax credit (APTC) through the Marketplace last year, you must file a Form 8962 with your federal income tax return in order to "reconcile" your estimated and actual income for the year, even if you estimated your income perfectly. You can get a blank Form 8962 from the IRS website, or, if you use tax preparation software, the form will be automatically generated for you. The instructions for Form…

  • I have COBRA, but it’s too expensive. Can I drop it during Marketplace Open Enrollment and enroll in a Marketplace plan instead?

    FAQs

    During Marketplace Open Enrollment, you can sign up for a Marketplace plan even if you already have COBRA. You will have to drop your COBRA coverage effective on the date your new Marketplace plan coverage begins. After Marketplace Open Enrollment ends, however, if you voluntarily drop your COBRA coverage or stop paying premiums, you will not be eligible for a special enrollment opportunity to enroll in a Marketplace plan and will have to wait until…

  • I heard the Affordable Care Act’s individual mandate ended. Does it still make sense to sign up?

    FAQs

    While there is no longer a federal tax penalty for being uninsured, some states (CA, MA, NJ, and RI) and DC have enacted individual mandates and may apply a state tax penalty if you lack health coverage for the year. Regardless of any tax penalty, it is still important to have insurance coverage to help reduce the risk of large medical bills if you get sick, to pay for medications, and to pay for check-ups…