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The ACA MarketplaceS

What We Know about Trump’s $500 ACA Checks and the User Fees Funding Them

This analysis examines the $500 checks that the Trump administration is sending to some Affordable Care Act Marketplace enrollees and the user fees that are paying for them. The checks are going to about 1 million enrollees in the 30 states that rely on the federal HealthCare.gov Marketplace who are not receiving any tax credits this year.

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. The enrollment decline coincides with the expiration of the enhanced premium tax credits and other policy changes that are expected to reduce enrollment.

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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  • Online Applications For Medicaid And/Or CHIP: An Overview of Current Capabilities And Opportunities For Improvement

    Issue Brief

    This analysis provides an overview of online applications for Medicaid and/or CHIP and examines the extent to which they incorporate features that streamline and simplify the enrollment process for individuals. Thirty-two states currently offer an online application for one or both of these programs that is accessible by the public and can be electronically submitted, although they vary in their features. A key component of the Patient Protection and Affordable Care Act is the creation…

  • Enhanced Medicaid Match Rates Expire in June 2011

    Fact Sheet

    This fact sheet discusses the role played by the enhanced federal Medicaid matching funds available to states through the American Recovery and Reinvestment Act of 2009 (ARRA), and the implications for state Medicaid programs as that extra assistance expires June 30, 2011. States used the ARRA enhanced Medicaid funding to address Medicaid funding shortfalls during the economic downturn, and to mitigate program cuts and address budget shortfalls. As national unemployment has increased in recent years…

  • Health Coverage for the Unemployed

    Issue Brief

    This policy brief outlines the challenges facing the unemployed as they seek to remain insured after losing jobs and employer-sponsored health coverage. In May 2011, 13.9 million people in the U.S. were unemployed. Of these, 6.2 million had been unemployed for six months or more and faced limited options to remain insured. The brief examines potential sources of insurance, including through a spouse's plan, COBRA, the non-group insurance market and public programs. It also discusses…

  • 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…

  • Ensuring Access to Care in Medicaid Under Health Reform

    Issue Brief

    This paper examines the key issues raised in a December 2010 roundtable discussion of federal and state officials and experts convened by the Kaiser Commission on Medicaid and the Uninsured to examine important issues related to ensuring access to care in Medicaid under the Patient Protection and Affordable Care Act (ACA). The ACA expands Medicaid to reach millions of low-income uninsured Americans and, recognizing current serious access problems system-wide, takes significant steps to build capacity…

  • Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries

    Issue Brief

    This issue brief identifies the major provisions in the Patient Protection and Affordable Care Act (ACA) that are designed to improve care and streamline service delivery for dual eligibles, the millions of low-income seniors and younger persons with disabilities who are enrolled in both the Medicaid and Medicare programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs; they comprise only 15 percent of total Medicaid enrollment…

  • May Kaiser Health Tracking Poll: Views of Health Reform Law Remain Unchanged

    Perspective

    This month’s Kaiser Health Tracking Poll reveals little change in public opinion about the health reform law. Americans remain divided overall, with 42 percent having a favorable opinion of the law and 44 percent viewing it unfavorably. Three in ten continue to want to see the law expanded, while roughly one in five want it either kept as is (21%), repealed and replaced with a GOP alternative (19%), or repealed outright (19%). Americans continue to…

  • Keeping Coverage Continuous: Smoothing the Path between Medicaid and the Exchange

    Event Date:
    Event

    A key challenge for those implementing the reform law is how to manage churning, when people cycle in and out of public programs as their income varies. What approaches are states and the federal government taking to minimize the disruption from churning? Will people be able to keep their provider as they move from Medicaid to private coverage and back? This briefing, sponsored by the Alliance for Health Reform and The Commonwealth, addressed these and…

  • Pulling It Together: Predictions

    Perspective

    I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS.  One reason for this is the lingering effect of the recession.  Employers will have little trouble attracting workers in the…

  • Accountable Care Organizations: A New Paradigm for Health Care Delivery?

    Event Date:
    Event

    The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the arrangements are burdensome and too hard to achieve. This briefing addresses questions raised by the law and the subsequent regulation implementing ACOs, including: How will…