Affordable Care Act

The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in 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 — May 2011

    Feature

    Most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and more than half want to see no reductions at all in Medicaid spending. One in five adults has received Medicaid benefits over time, and for most, experiences were positive, although one third of them report having had problems finding a doctor. The findings come at a time of intense public debate in Washington about the future of…

  • Kaiser Health Tracking Poll — August 2010

    Feature

    The August Health Tracking Poll finds that support for health reform fell over the course of August, dipping from a 50 percent favorability rating in July to 43 percent, while 45 percent of the public reported unfavorable views. The dip in favorability returned public opinion on the new law to the even split last seen in May before a modest uptick in support in June and July. Americans’ views of how reform will affect them…

  • Kaiser Health Tracking Poll — March 2012

    Feature

    As the oral arguments on the Affordable Care Act (ACA) begin in two weeks before the Supreme Court, the March Kaiser Health Tracking Poll finds that Americans' views on the case mirror their views on the health reform law and that they expect parts of the ACA to continue whatever the Court rules. The poll finds that half of all Americans (51%) think the Court should rule the mandate unconstitutional and about the same number…

  • Pop Quiz: Assessing Americans’ Familiarity With the Health Care Law

    Feature

    The Affordable Care Act (ACA) is coming up on a year old, but in the midst of continuing debate over the merits of the landmark health care overhaul, how well do Americans understand what the new law will actually do? As the 112th Congress prepared to take office and the discussion of repeal was on the rise, the Foundation included a ten-question "quiz" on the December Kaiser Health Tracking poll to try to answer this…

  • Kaiser Health Tracking Poll — October 2010

    Feature

    With the November midterm elections just weeks away, Americans remain chronically divided over the Patient Protection and Affordable Care Act, but most say that their feelings – pro and con – about the health reform law are not a dominant factor in how they will vote for Congress or whether they will go to the polls. Views on health reform tightened up in October, with 42 percent saying they have favorable views of the new…

  • Medicaid Coverage and Spending in Health Reform: National and State-By-State Results for Adults at or Below 133% FPL

    Report

    This analysis, performed by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, shows that the expansion of Medicaid under the health reform law will significantly increase the number of people covered by the program and reduce the uninsured in states across the country, with the federal government picking up the vast majority of the cost. The analysis is among the first to show for all 50 states and the District of…

  • Governors’ Budgets for FY 2013 — What is Proposed for Medicaid?

    Issue Brief

    This report provides Medicaid highlights from governors' proposed state budgets for FY 2013, which starts July 1, 2012 for most states. While some states are beginning to see signs of economic recovery, many remain cautiously optimistic as they continue to experience the recession's lingering effects. State revenues have not rebounded to pre-recession levels, unemployment rates are still high, and some states continue to face budget shortfalls. There continues to be high demand for Medicaid and…

  • Kaiser Health Tracking Poll — January 2012

    Feature

    As the Supreme Court prepares to hear legal challenges to the health reform law in March, most Americans expect the Justices to base their ruling on their own ideological views rather than their interpretation of the law, according to the January Health Tracking Poll. Other key findings include: The public doubts the Supreme Court renders judgments based solely on the law. Three-quarters (75%) say they think that, in general, Justices let their own ideological views…

  • Kaiser Health Tracking Poll — November 2011

    Feature

    The November Health Tracking Poll takes a closer look at public opinion and knowledge about specific provisions of the Patient Protection and Affordable Care Act (ACA). Findings include: After taking a negative turn in October, the public's overall views on the ACA returned to a more mixed status this month. Still, Americans remain somewhat more likely to have an unfavorable view of the law (44%) than a favorable one (37%). The survey also finds that…

  • Kaiser Health Tracking Poll — June 2010

    Feature

    The start of summer finds Americans remain divided on the health reform law, but favorable views of the new law increased seven percentage points over the past month to 48 percent, compared to 41 percent who have “generally unfavorable” views and 10 percent who have yet to make up their minds. With four months remaining until the midterm congressional elections, an early look suggests that the contests could be impacted by a number of different…