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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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  • September Kaiser Health Tracking Poll: Pre-Existing Conditions

    Perspective

    With several elements of the ACA targeted toward individuals with pre-existing conditions, this month’s Kaiser Health Tracking Poll takes a closer look at this group. Fifty-two percent of Americans say that they or someone else in their household has what would be considered a “pre-existing condition,” and among this group, one in five (21 percent) say they or their family member has had difficulty getting health insurance because of this condition. Yet many of these people…

  • Kaiser Health Tracking Poll: Support for Health Reform Law Dips in October

    Perspective

    After remaining roughly evenly split for most of the last year and a half, this month’s tracking poll found a higher share of the public expressing negative views towards the health reform law. About half (51 percent) say they have an unfavorable view of the Patient Protection and Affordable Care Act (ACA), while 34 percent have a favorable view, a low point in Kaiser polls since the law was passed. While Democrats continue to be substantially…

  • Health Reform and the Art of Federalism

    Perspective

    The U.S. Department of Health and Human Services (HHS) recently announced significant changes to the premiums charged in the Pre-existing Condition Insurance Plan (PCIP), aka the "high risk pool" created by the Affordable Care Act. Premiums will now be up to 40% lower depending on the state (in some states the cost to enrollees is unchanged), and application procedures will be eased. The PCIP plans provide coverage for people who cannot buy coverage in the…

  • CBO’s Estimate of Repealing Exchange Grants: The Importance of Being Effective

    Perspective

    The Congressional Budget Office (CBO) recently released an analysis of a bill that would repeal grants to states under the health reform law to help them establish health insurance purchasing exchanges. Not surprisingly, CBO finds that the bill would reduce federal spending due to the fact that expected grants won't be provided, to the tune of $1.9 billion over ten years. But, that's not the biggest effect on the federal budget. CBO also finds that…

  • June Kaiser Health Tracking Poll: Americans Still Divided on Health Reform Law

    Perspective

    In the latest Kaiser Health Tracking Poll, the public remains divided in their overall assessments of the ACA, with 42 percent holding a favorable view of the law and 46 percent an unfavorable one. This month’s poll finds Americans are somewhat more likely to think their own families, seniors as a group, and the Medicare program will be worse off rather than better off under the law, though large shares say they don’t know or…

  • Peering Into the Black Box of Insurance Rating

    Perspective

    Recently, the New York Times reported that private health insurers continue to seek large premium increases despite seeing lower than expected use of medical care and booking record profits. The story highlights a significant problem for health policy: the lack of good, public information about how health insurers manage health care use and what they pay for medical services. As a nation, we rely on competition among largely private health plans to ensure that health…

  • Who Will be the H&R Block and TurboTax for Health Insurance?

    Perspective

    There's been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as "producers"). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that would exempt agent and broker commissions for health insurance from minimum medical loss ratio (MLR) thresholds established in the health reform law. (The MLR is…

  • KFF March Health Tracking Poll: One Year Later, Views on Health Reform Remain Divided

    Perspective

    Health reform is a year old and the latest Kaiser Health Tracking Poll finds a basic division that has changed little during the last 12 months. This month, 42 percent of Americans hold favorable views of the law while 46 percent view it unfavorably. In April 2010, the month after passage, 46 percent had favorable views and 40 percent unfavorable ones, but both figures have ticked up and down over the last year. Opinion of…

  • Measuring the Affordability of Employer Health Coverage

    Perspective

    A recent draft regulation issued by the Treasury Department describes who is eligible for premium tax credits to help them afford coverage offered through health insurance exchanges beginning in 2014. Tax credits will be available to people with incomes between 100 and 400 percent of the poverty level who are not eligible for public coverage such as Medicaid or Medicare and who are not offered affordable health coverage by an employer. The approach that the…