Affordable Care Act

The ACA MarketplaceS

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

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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  • Getting into Gear for 2014: Insights from Three States Leading the Way in Preparing for Outreach and Enrollment in the Affordable Care Act

    Issue Brief

    This report provides insight into preparations in Maryland, Nevada, and Oregon -three states that have established a State-based Marketplace, are moving forward with the Medicaid expansion, and are among the states leading the way in preparing for outreach and enrollment. e findings provide an overview of where these three states are in establishing their Marketplaces; preparing for the Medicaid expansion; planning for marketing, outreach and enrollment; and establishing enrollment assistance resources. It highlights the challenges…

  • Providing Outreach and Enrollment Assistance: Lessons Learned from Community Health Centers in Massachusetts

    Issue Brief

    As states and communities gear up to provide outreach and enrollment assistance under the ACA, the enrollment assistance experience of health centers in Massachusetts, where a major expansion of health coverage was implemented six years ago, offers valuable lessons that can help to inform current and emerging efforts by health centers and other community-based organizations to reach and enroll millions of low-income, uninsured Americans in health insurance.

  • Visualizing Health Policy: Premium Subsidy Scenarios Under Obamacare

    Other Post

    This month’s Visualizing Health Policy infographic shows 3 scenarios that illustrate the cost of health insurance under the Affordable Care Act for families in different circumstances, both before and after premium subsidies (in the form of a tax credit).

  • Getting into Gear for 2014: An Early Look at Branding and Marketing of New Health Insurance Marketplaces

    Issue Brief

    Based on a review of publicly available materials as of September 2013, this brief provides an examination of the Marketplace branding strategies, websites, and marketing materials, providing insight into how consumers will be introduced to the Marketplaces and some of the key messages and approaches the Marketplaces will utilize to encourage individuals to enroll. As of September 2013, states and the federal government are on the eve of their October 1st launch of open enrollment…

  • Web Briefing for Journalists: How ACA’s Employer Requirements and Related Provisions Affect Businesses and Workers

    Event Date:
    Event

    A major piece of the Affordable Care Act will first take effect January 1 when larger employers will be required to offer coverage to their workers or face penalties. How do the penalties work and how are they being phased in? To help reporters understand and cover these issues, the Kaiser Family Foundation held a web briefing exclusively for journalists.

  • Medicaid Expansion in Red States

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explains that Tennessee Gov. Bill Haslam's decision on Medicaid expansion via the Affordable Care Act is the latest sign of pragmatism slowly winning over ideology in red states.

  • Majority Favors the Affordable Care Act’s Employer Mandate, But Opinion Can Shift When Presented With Pros and Cons

    News Release

    Recent news stories on the heath law did not attract most Americans’ attention, and many are unaware of details and implications of the developments Weeks before the Affordable Care Act’s employer mandate takes effect in January, a new Kaiser Family Foundation tracking poll finds that six in 10 Americans (60%) say they have a favorable view of the provision, which in 2015 requires employers with 100 or more full time workers to offer health coverage…

  • Issue Brief Looks At Experiences of People with HIV With Health Coverage Under the ACA

    News Release

    A new Kaiser Family Foundation issue brief examines the impact of the Affordable Care Act (ACA) on people with HIV in five states – California, Florida, Georgia, New York and Texas. Findings are drawn from focus groups in which participants discussed their experiences during the first year of the ACA’s major coverage expansions, with the goal of understanding the implications for individual HIV health outcomes and the nation's response to the epidemic. While many focus group…

  • Which Path for Health-Care Politics in 2015?

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on January 6, 2015. Yogi Berra said that when you come to a fork in the road, take it. It will be that kind of year for health-care politics. The status quo is not an option. The key to which path the Affordable Care Act takes is how the Supreme Court rules in King v. Burwell, the case that concerns whether subsidies in the health law can be…