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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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  • A Profile of Health Insurance Exchange Enrollees

    Report

    The Patient Protection and Affordable Care Act calls for the creation of Health Insurance Exchanges in all states by January 1, 2014. The exchanges are a critical element of the health reform law, aimed at helping individuals and families shop for and purchase health insurance on their own with additional assistance for lower-income individuals and families. The Congressional Budget Office has estimated that approximately 24 million people will purchase coverage through the state health exchanges…

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • How Will Consumers Navigate New Health Care Options? Briefing and Panel Discussion

    Event Date:
    Event

    With the open enrollment period for health insurance exchanges less than six months away, consumers are already asking questions about their new health care options under the Affordable Care Act (ACA). Even in the age of digital information, hands-on consumer assistance could play a key role in helping people understand their insurance choices come 2014 — a recent Kaiser Family Foundation poll showed that two thirds of the uninsured and a majority of Americans overall…

  • Federal Funding Under the Affordable Care Act

    Fact Sheet

    This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to state and local governments (including state and local health departments and school districts) and private entities (including private employers, health centers, universities, and other community-based…

  • Health Affairs Article: Comparing the Assets of Uninsured Households to Cost Sharing Under High Deductible Health Plans

    Issue Brief

    Health Affairs Article: Comparing the Assets of Uninsured Households to Cost Sharing Under High Deductible Health Plans Relatively few uninsured households have enough financial assets to cover the cost-sharing in consumer-driven health plans tied to Health Savings Accounts (HSAs), according to this study by Kaiser Family Foundation researchers published as a Health Affairs Web Exclusive on April 15, 2008. Consumer-driven plans generally require enrollees to pay for most health-care expenses themselves until they reach the plan’s relatively high…

  • Consumer Choice in Health Care: How Could Reform Affect Our Choices? How Could We Make Better Choices?

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this event which brought together nationally known health policy experts for a conversation on consumer choice in health care. Panelists addressed the following questions: Why is choice of health care providers important? How much choice do we really have now? How much choice do we need? How might health reform affect our choices? In some instances, do we have too much choice? How…

  • Study Finds Recent Slowdown in Health Spending Growth Mostly Tied to the Economy

    News Release

    Growth Expected To Move Towards Historical Levels In Coming Years As the Economy Recovers A new Kaiser Family Foundation analysis of how the economy affects the nation’s health spending concludes that the record slow growth rate of recent years stems largely from economic factors beyond the health system, with the economy explaining 77 percent of the slowdown, and more rapid growth expected in coming years if the economy strengthens as expected. Based on statistical modeling…

  • Oral Histories: Report from a Dental Fair

    Video

    This video profiles patients attending a dental fair in rural Virginia and highlights the impact of lack of coverage for oral health services. Uninsured adults have vast oral care needs, and untreated dental problems can have serious health, employment and social consequences.

  • Explaining Health Care Reform: Medical Loss Ratio (MLR)

    Fact Sheet

    This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and…