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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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  • Nine Changes to Watch in ACA Open Enrollment 2023

    Policy Watch

    The 2023 Affordable Care Act (ACA) Open Enrollment period will run from November 1, 2022 to January 15, 2023 in most states, longer in some state-based marketplaces. This policy watch examines nine changes that may affect what enrollees pay for coverage, the size of tax credits for those eligible, and other changes that could affect enrollees' experiences.

  • 2022 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2022 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

  • 2022 Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: Esta calculadora ha sido actualizada con los cambios a los subsidios en el American Rescue Plan Act de 2021 (el acta de alivio por COVID-19). Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act,…

  • This chart shows that almost 1,300 hospitals have been penalized for high readmissions rates every year.

    10 Years of Hospital Readmissions Penalties

    Feature

    Over the 10-year lifetime of a Medicare program aimed at reducing hospital readmissions, 93% of eligible hospitals have been penalized at least once. Hospital readmissions have become less frequent, and most experts attribute that partly to the financial threat of the penalties, though other factors likely contributed to the improvements.

  • Summary of Costs and Impact of the Prescription Drug Provisions in the Build Back Better Act

    News Release

    As the House-passed Build Back Better Act moves to the Senate, a new explainer from KFF summarizes the key prescription drug provisions within the broader budget reconciliation bill. These provisions would lower prescription drug costs paid by people with Medicare and private insurance and curb drug spending by the federal government and private payers. The Congressional Budget Office estimates federal budget savings from the drug pricing provisions would be $297 billion over 10 years. Although…

  • County-Level Analysis Finds ACA Premiums are Falling in Many Areas of the Country, Though Changes Vary by County and Type of Plan

    News Release

    Premiums for the Affordable Care Act Marketplace benchmark silver plan are decreasing 3.1 percent on average across the country – the fourth year in a row that benchmark premiums have fallen – though the changes vary by county, a new KFF county-by-county analysis finds. The benchmark plan premiums are important because they are used to determine the tax credits available to people who buy their own insurance through the Marketplaces. What people would have to…

  • This graphic explains the main features of new surprise billing protections.

    No Surprises Act Implementation: What to Expect in 2022

    Issue Brief

    The “No Surprises Act,” which establishes new federal protections against most surprise out-of-network medical bills when a patient receives out-of-network services during an emergency visit or from a provider at an in-network hospital without advance notice, will take effect next month. A new KFF brief outlines what to expect in 2022.

  • Consumer Appeal Rights in Private Health Coverage

    Issue Brief

    The Affordable Care Act (ACA) gives consumers the right to appeal private health plan claims denials and other adverse decisions, including the incorrect application of cost sharing, although limits apply. This issue brief describes consumer access to appeals and limits on appeal rights that have been adopted through federal regulations.

  • This chart shows how the prevalence of surprise bills varies by condition.

    Before New Ban, the Prevalence of Surprise Bills

    Feature

    Patients with certain conditions appear to be at higher risk for receiving surprise bills. They should be aware of new federal protections against surprise bills and know how to seek out help if they have improperly received one.