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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  • Health Reform Implementation Timeline

    Interactive

    The health reform implementation timeline is an interactive tool designed to explain how and when the provisions of the Affordable Care Act will be implemented over the next several years.

  • Americans Remain Split On Stalled Health Care Legislation, but Some Provisions Popular Among Majorities of Democrats, Independents and Republicans

    News Release

    Most See Delays As Driven By Politics Rather Than Policy MENLO PARK, CA – The latest Kaiser Tracking Poll finds the public still split on health care reform legislation, with 43 percent in favor and 43 percent opposed.  However, the poll also finds that majorities of Americans of all political leanings support several provisions in the health reform proposals in Congress and most attribute delays in passing the legislation to political gamesmanship rather than policy…

  • Mapping the Effects of the ACA’s Health Insurance Coverage Expansions

    Interactive

    The Foundation originally released this interactive tool in February 2012.  More recent analysis of the Affordable Care Act's potential impact on each state's uninsured population can be accessed through this interactive tool and these individual state reports. The Affordable Care Act includes several provisions that allow many individuals across the U.S. to be eligible for Medicaid or for federal tax credits to subsidize the cost of insurance. The analysis below and zip code tool estimate…

  • Ensuring the Health Care Needs of Women: A Checklist for Health Exchanges

    Issue Brief

    To inform the development of the state health insurance Exchanges under the Affordable Care Act, this checklist identifies key coverage, affordability and access issues that are important for women. Based on lessons learned from women’s health research and the Massachusetts experience, the checklist considers essential health benefits, implementation of no-cost preventive services including contraception, provider networks and affordability, outreach and enrollment efforts, and the importance of including gender and other demographic characteristics in data collection…

  • Can We Learn From ACA Implementation and Improve the Law?

    From Drew Altman

    Senator Baucus made headlines recently when he predicted a “train wreck” for Obamacare. David Brooks predicted “chaos” in a recent column. In a news conference, the President offered a different perspective.  “There’ll still be, you know, glitches and bumps…. That’s pretty much true of every government program that’s ever been set up,” Obama said. “But if we stay with it, and we understand what our long-term objective is, which is making sure that in a…

  • Window of Opportunity?

    From Drew Altman

    Beginning this Spring, between expected approval of an economic stimulus package and the start of campaigning for the midterm election, there will be a rare window of opportunity for passage of major health reform legislation. History suggests that momentum can be lost if policymakers do not move quickly to seize these rare openings when they occur. There is an opportunity now because the nation has a popular new president with political capital to burn who…

  • On Health Care, Conservatives Protest Too Much

    From Drew Altman

    Lately conservatives have been feeling like losers in health care and complaining loudly about it. They don't like Obamacare or the increase in the government's role in health care or the federal spending it brings with it, even if those things result in coverage for more than 30 million uninsured Americans and new protections from the worst abuses in the health insurance industry. Actually, conservatives are winning at least as much as they are losing…

  • Women’s Health Quiz: Health Coverage and the Affordable Care Act

    Feature

    Health insurance coverage is a critical factor in making health care accessible to women—women with health coverage are more likely to obtain needed preventive, primary, and specialty care services. Test your knowledge of women’s health coverage and the effect of the Affordable Care Act on women with our ten-question quiz.