Affordable Care Act

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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  • Keeping the Alexander-Murray Health Care Bill in Context

    From Drew Altman

    This Drew Altman Axios column describes the scale of the problems in the ACA marketplaces and the public’s confusion about whether they are impacted. He says that the news media, experts and policy makers can do more to put the marketplace problems and fixes in context as debate evolves.

  • ANALYSIS: ACA Silver Plan Premium Increases from 7% to 38% Attributed to End of Cost-Sharing Payments

    News Release

    Insurers factored in premium increases ranging from 7 percent to 38 percent exclusively in silver plans to absorb the financial impact of the loss of cost-sharing reduction payments from the federal government, a new Kaiser Family Foundation analysis finds. The approach, used by insurers in many states, shields consumers from steep rate hikes, because tax credits defraying the cost of premiums rise dollar-for-dollar along with benchmark silver rates. Eighty-four percent of marketplace enrollees received premium…

  • How Premiums Are Changing In 2018

    Issue Brief

    Maps illustrate how premiums in Affordable Care Act (ACA) marketplaces changed for 2018 by looking at the change in the lowest-cost bronze, silver and gold plans by county; counties where an individual’s tax credit covers the full premium of the lowest-cost bronze plan; and counties where the unsubsidized premium for the lowest-cost gold plan has a lower or comparable premium to the lowest-cost silver plan in 2018.

  • One Big Thing People Don’t Know About Single Payer

    From Drew Altman

    In this Axios column, Drew Altman discusses a challenge for single payer which has not received much attention – a large share of the American people do not think they would have to change their current health insurance arrangements if there were a Medicare-for-all style single payer plan.

  • FAQs: What’s the Latest on IPAB?

    Issue Brief

    The Independent Payment Advisory Board was authorized by the Affordable Care Act to help slow the growth in Medicare spending. These FAQs address common questions about IPAB, including how it was designed to operate and the implications of eliminating it.

  • How Many of the Uninsured Can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Penalty?

    Issue Brief

    For people who are uninsured and eligible for Affordable Care Act (ACA) marketplace plans, the analysis compares the cost of a premium for the lowest-cost bronze plan with the estimated individual mandate tax penalty for 2018. It finds that more than half (54% or 5.9 million) of the 10.7 million people could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

  • Individual Mandate Penalty Calculator

    Interactive

    The Individual Mandate Penalty Calculator estimates your penalty for going uninsured vs. how much you would pay for health insurance coverage on the Affordable Care Act (ACA) marketplaces.