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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.

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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  • Updated FAQs Provide New Answers as the Affordable Care Act’s Marketplace Enters Its Second Year

    News Release

    Today, the Kaiser Family Foundation released an updated collection of Frequently Asked Questions (FAQs) providing detailed answers for consumers, and the navigators and brokers who assist them, as the Nov. 15 start date nears for the Affordable Care Act's second open enrollment period. The searchable collection includes nearly 300 up-to-date responses, answering new questions about plan renewal, cancellations, and continuing financial assistance. The FAQs also offer guidance for understanding 2014 federal income taxes in the…

  • The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs

    Report

    The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015.…

  • Kaiser Calculator Now Gives Consumers 2015 Zip Code-Specific Premium and Tax Credit Estimates for Marketplace Coverage

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator now includes zip code-specific data on 2015 health plans that are being sold through the Affordable Care Act’s insurance marketplaces during the open enrollment period beginning Saturday, Nov. 15. With the new tool, consumers around the nation can generate estimates of their health insurance premiums and government subsidies for 2015 plans that they purchase on their own through an ACA marketplace. The estimates are based on zip…

  • Estimating Federal Payments and Eligibility for Basic Health Programs: An Illustrative Example

    Report

    In some states, policymakers and stakeholders are considering adoption of the Basic Health Program (BHP) option permitted under the Patient Protection and Affordable Care Act (ACA). Federal regulations allow BHP implementation beginning in 2015. Through BHP, consumers with incomes at or below 200 percent of the federal poverty level (FPL) who would otherwise qualify for subsidized qualified health plans (QHPs) offered in health insurance marketplaces instead are offered state-contracting standard health plans that provide coverage…

  • Web Briefing: Early Impacts of the Medicaid Expansion for the Homeless Population

    Event Date:
    Event

    The Affordable Care Act’s Medicaid expansion provides a significant opportunity to increase health coverage and improve access to care for individuals experiencing homelessness, who historically have had high uninsured rates and often have multiple, complex physical and mental health needs. On Monday, December 15, 2014, the Kaiser Family Foundation hosted a web briefing to examine the early impacts of the ACA’s Medicaid expansion on the homeless population, as well as opportunities and challenges looking forward.  The…

  • JAMA Forum: Why Health Insurance Literacy Matters

    Perspective

    Larry Levitt's November 2014 post looks at the challenges with people not understanding basic health insurance concepts as millions of them evaluate and choose health plans during open enrollment season for insurance in 2015.

  • Assessing the Performance of the U.S. Health System

    Issue Brief

    Health spending growth has consistently outpaced U.S. economic growth and is higher than medical spending in other wealthy countries. Despite spending more, the United States doesn't have better health outcome in terms of life expectancy, mortality rates and other measures. This brief provides an overview of trends in health costs and the performance of the U.S. health system, including comparisons to countries from the Organisation for Economic Co-operation and Development (OECD). The brief charts growth…

  • Statement of Gary Claxton to NAIC Exchanges (B) Subgroup

    Event Date:
    Event

    Kaiser Family Foundation Vice President Gary Claxton, who directs the Foundation's Marketplace Policy Project, testified July 22, 2010, at a public hearing before the National Association of Insurance Commissioners' Exchanges (B) Subgroup established by the health reform law.  Testimony (.pdf)

  • 50 Ways to Implement Health Reform: State Challenges and Federal Assistance

    Event Date:
    Event

    This briefing looks into the key challenges facing states, including working within state legislative cycles against tight deadlines in the federal law, creating new roles at the state level as state budgets are being squeezed, and others. It looks at both near-term provisions, such as high risk pools, as well as other provisions farther down the road, such as setting up exchanges and instituting changes to Medicaid eligibility. This August 2 briefing was cosponsored by…