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Affordable Care Act

The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • In Depth Analysis of Health Reform Issues

    Report

    These reports provide in-depth analysis related to the health reform debate. Additional reports will be added as they become available. Medicaid Expansion in Health Reform: National and State Estimates of Coverage and CostsThis analysis and public briefing examine the potential national and state-by-state impacts on Medicaid enrollment and spending of the expansion of coverage for low-income adults under the health reform law. Reform Calculator Estimates Premiums and Subsidies Available In 2014The Foundation's interactive health reform…

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • Health Reform: Lessons From Massachusetts

    Event Date:
    Event

    As Congress debates comprehensive national health reform, the Kaiser Family Foundation has two reports and an updated fact sheet that examine state-level health reform in Massachusetts and the lessons it offers for policymakers in Washington. Consumers’ Experience in Massachusetts: Lessons For National Health Reform and In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts, examine the impact of health reform on the lives of ordinary people in the state, including…

  • Health Reform and Communities of Color: Implications for Racial and Ethnic Health Disparities

    Issue Brief

    This issue brief examines the key provisions of the 2010 health reform law that will expand health coverage and are likely to improve access to care for people of color, as well as some of the other provisions that will likely have either a direct or indirect impact on health disparities. Issue Brief (.pdf)) Previous Version: November 2009 (.pdf)

  • Quick Take: Geographic Variation in Dual Eligible Enrollment

    Fact Sheet

    Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs.  These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).  Dual eligibles are among the sickest and poorest individuals covered by Medicare and Medicaid and, as a group, account for a disproportionate…

  • A Focus Group with Medicaid Directors: As FY 2012 Ends, Looking Toward FY 2013

    Report

    This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid spending and enrollment trends, key Medicaid policy changes and federal health care reform implementation. At the time of the meeting, most states were wrapping up…

  • Faces of the Medicaid Expansion: Experiences and Profiles of Uninsured Adults Who Could Gain Coverage

    Issue Brief

    These two papers provide insight into how state decisions to expand Medicaid under the Affordable Care Act are likely to impact people. Based on focus groups and interviews conducted in Cincinnati, Houston, Las Vegas and Tampa with uninsured adults who could be eligible for the Medicaid expansion in 2014, these papers highlight the experiences of uninsured adults and the significant health and financial consequences of being uninsured, which sometimes impact their ability to work and…

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Expanding Medicaid to Low-Income Childless Adults Under Health Reform: Key Lessons From State Experiences

    Issue Brief

    The health reform law will expand Medicaid to millions of low-income adults, including many childless adults who have historically been ineligible for the program, necessitating one of the largest enrollment efforts in the program's history. This report, based on interviews with officials in seven states and the District of Columbia and national experts, examines lessons learned from past state experience covering childless adults through waiver and state-funded programs and profiles the programs included in the…

  • Building an Information Technology Foundation for Health Reform: A look at Recent Guidance and Funding Opportunities

    Issue Brief

    The major coverage provisions in the Affordable Care Act (ACA) go into effect in January 2014 with an expansion of Medicaid eligibility to nearly all individuals under 138% of poverty and new subsidies for individuals with incomes between 138% and 400% of poverty to purchase coverage in newly established Health Insurance Exchanges. The ACA envisions a streamlined and simplified application process with seamless transitions between coverage in the Exchange and Medicaid. Using a web portal,…