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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  • State Marketplace Profiles: Hawaii

    Other Post

    Final update made on November 6, 2013 (no further updates will be made)  Establishing the Marketplace On July 11, 2011, Governor Neil Abercrombie (D) signed SB 1348 into law establishing the Hawaii Health Connector, a State-based health insurance Marketplace.1  The law builds on Hawaii’s Prepaid Health Care Act of 1975 (PHCA) which required nearly all employers to provide health insurance to employees working 20 or more hours a week for four consecutive weeks.2  Structure: The legislation established the…

  • State Exchange Profiles: Indiana

    Other Post

    Final update made on December 13, 2012 (no further updates will be made)  Establishing the Exchange In November 2012, Governor-elect Mike Pence (R) announced that he would not move forward with setting up a state-based health insurance exchange when he takes office in 2013.1 During his term, Governor Mitch Daniels (R) had signed Executive Order #11-01 in 2011 to conditionally establish and operate the Indiana Insurance Market, Inc., a nonprofit corporation to serve as the…

  • State Marketplace Profiles: Arkansas

    Other Post

    Final update made on October 29, 2013 (no further updates will be made) Establishing the Marketplace On December 12, 2012, Governor Mike Beebe (D) informed federal officials that Arkansas would pursue a state-federal partnership health insurance Marketplace (also referred to as exchange).1  A state opting for a partnership Marketplace can choose to operate plan management functions, consumer assistance functions, or both. A state can also elect to perform Medicaid and Children’s Health Insurance Program (CHIP)…

  • State Marketplace Profiles: Kentucky

    Other Post

    Final update made on November 11, 2013 (no further updates will be made) Establishing the Marketplace On July 17, 2012, Governor Steven L. Beshear (D) issued Executive Order 587 establishing the Kentucky Health Benefit Exchange (KHBE) after the Supreme Court ruled to uphold the Affordable Care Act (ACA).1  In May 2013, the state announced that its online Marketplace would be called kynect. Prior to the Executive Order, the Kentucky Cabinet for Health and Family Services led Marketplace…

  • In Employer Health Insurance Costs, Stability Is the New Normal

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman looks at the sharply slower growth in premiums for employer health benefits and what it might mean for the future of employer-sponsored coverage.

  • Low-Wage Workers Feel the Pinch on Health Insurance

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explores how low-wage firms and their workers are faring in the employer-based health insurance market and how the Affordable Care Act may influence future trends.

  • Report Provides Insights from Consumer Assisters on Improving Affordable Care Act’s Next Open Enrollment

    News Release

    A new report from the Kaiser Family Foundation and Robert Wood Johnson Foundation captures insights from those who helped consumers navigate the Affordable Care Act's first open enrollment period, including lessons for the second , which is set to start Nov. 15. “Taking Stock and Taking Steps: A Report from the Field after the First Year of Marketplace Consumer Assistance Under the ACA” draws on the experiences of 80 program leaders who participated in a…

  • Why Public Interest Is Cooling in Obamacare as a Political Story 

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman reviews indicators pointing to the Affordable Care Act cooling as a front-page issue, while hot debate continues about it among partisans and experts. All previous columns by Drew Altman are available online.

  • Implementing the ACA: Medicaid Spending & Enrollment Growth for FY 2014 and FY 2015

    Issue Brief

    This report provides an overview of Medicaid financing and Medicaid spending and enrollment growth with a focus on state fiscal years 2014 and 2015 (FY 2014 and FY 2015.) Findings are based on interviews and data provided by state Medicaid directors as part of the 14th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) survey with Health Management…