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

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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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  • KFF Tracking Poll: More Than a Third of Americans Say They’ve Struggled to Pay Living Expenses Since December; 6 in 10 Families Hit by COVID Have Lost A Job or Income

    News Release

    Majorities Favor Provisions to Expand Marketplace Tax Credits and Encourage States to Expand Medicaid As Congress considers an additional $1.9 trillion COVID-19 relief plan, more than a third (37%) of Americans say that someone in their household has had trouble paying basic living expenses over the past three months, the latest KFF Health Tracking Poll finds. This includes nearly 1 in 4 (23%) who say they have fallen behind on their credit card bills, and…

  • 2021 Calculator – Before COVID-19 Relief

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2021 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). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • What about premiums I already paid in 2021?

    FAQs

    The higher premium subsidies are in effect for the 2021 and 2022 plan years.  For premiums you already paid in 2021, before the new law passed, you can claim the increased tax credit when you file your federal income tax return.

  • What happens after the COBRA subsidies end in September?

    FAQs

    You can continue on COBRA unsubsidized until your 18 months of COBRA eligibility ends. In addition, you will have the option to enroll in marketplace coverage when the subsidy ends in September.  Loss of the COBRA subsidy will make you eligible for a special enrollment period (SEP) to sign up for marketplace coverage.  If you make your plan selection before the end of September, new marketplace coverage will take effect on October 1. 

  • I just got laid off. I am eligible for 6 months of COBRA subsidy, also eligible for Medicaid. Can I choose option that is best for me?

    FAQs

    Yes, eligibility for COBRA does not affect your eligibility for Medicaid or vice versa.  Medicaid also offers premium-free coverage (in some states Medicaid charges a nominal monthly premium for some adults) with no or nominal cost sharing.  As you consider options, you will want to compare provider networks, cost sharing, covered benefits, other plan features. If you elect COBRA, remember the subsidy ends no later than September 30, 2021.  If income remains at or below…

  • How Has the Pandemic Affected Health Coverage in the U.S.?

    Policy Watch

    Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces.