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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.

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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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  • Early Implementation Experience of Medicaid Expansion Waivers in Michigan and Indiana Can Help Inform Future Medicaid Waivers

    News Release

    Michigan and Indiana, led by Republican governors, each obtained a waiver from the Obama Administration to expand Medicaid in ways that differ from the terms of the Affordable Care Act. Notably, both states’ expansions include provisions related to charging enrollees premiums, requiring them to contribute to health accounts and providing incentives to participate in healthy behavior programs, though the details and implementation vary considerably between the two states. A new analysis from the Kaiser Family…

  • Estimates: Average ACA Marketplace Premiums for Silver Plans Would Need to Increase by 19% to Compensate for Lack of Funding for Cost-Sharing Subsidies

    News Release

    A new Kaiser Family Foundation analysis finds that the average premium for a benchmark silver plan in Affordable Care Act (ACA) marketplaces would need to increase by an estimated 19 percent for insurers to compensate for lost funding if they don’t receive federal payment for ACA cost-sharing subsidies. Established by the health law to reimburse insurers for the cost of reducing out-of-pocket costs for lower-income people buying marketplace plans (with incomes from 100% to 250%…

  • Three Quarters of the Public, Including a Majority of Trump Supporters, Want President Trump to Try to Make the Affordable Care Act Work

    News Release

    Americans See Many Factors Behind AHCA’s Failure, But Few Republicans Blame President Trump Despite divided views about the Affordable Care Act, three-fourths of the public (75%) say President Trump and his administration should do what they can to make the law work, while one in five (19%), including 38 percent of Republicans, say the Administration should do what it can to make the law fail so they can replace it later, the latest Kaiser Health…

  • A Warning From the Polls About Letting Obamacare “Explode”

    From Drew Altman

    In this column for Axios, Drew Altman sees a warning for the Trump administration and Republicans in the latest Kaiser Tracking Poll: the more they do to undermine the Affordable Care Act marketplaces the more the public is likely to hold them, and not the Democrats, accountable for the problems with the law.

  • JAMA Forum: Is the Affordable Care Act Imploding?

    Perspective

    In this April 2017 post, Larry Levitt discusses the current status of the Affordable Care Act's health insurance marketplaces, and explains how the Trump administration's choices -- including whether to continue cost-sharing reduction payments to insurers -- could influence stability of the marketplaces going forward. The post is now available at The JAMA Forum.

  • Why Trump’s Dealmaking Model Doesn’t Fit Health Care Policy

    From Drew Altman

    In this column as an Axios contributor, Drew Altman discusses President Trump's threat to withhold cost sharing subsidies and questions whether his approach to deal making can bridge health care's partisan and ideological divide. "Health policy is not like real estate," he says.

  • The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments

    Issue Brief

    This analysis estimates that total federal spending on Affordable Care Act marketplace subsidies would rise $2.3 billion, or 23 percent, in 2018 if payments for the cost-sharing reduction program were eliminated and insurers increased premiums to compensate. Established to reduce out-of-pocket costs for marketplace enrollees with lower incomes, the cost-sharing payments are being challenged in a lawsuit from the U.S. House.