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The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in 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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  • Health Affairs Article: Comparing the Assets of Uninsured Households to Cost Sharing Under High Deductible Health Plans

    Issue Brief

    Health Affairs Article: Comparing the Assets of Uninsured Households to Cost Sharing Under High Deductible Health Plans Relatively few uninsured households have enough financial assets to cover the cost-sharing in consumer-driven health plans tied to Health Savings Accounts (HSAs), according to this study by Kaiser Family Foundation researchers published as a Health Affairs Web Exclusive on April 15, 2008. Consumer-driven plans generally require enrollees to pay for most health-care expenses themselves until they reach the plan’s relatively high…

  • Consumer Choice in Health Care: How Could Reform Affect Our Choices? How Could We Make Better Choices?

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this event which brought together nationally known health policy experts for a conversation on consumer choice in health care. Panelists addressed the following questions: Why is choice of health care providers important? How much choice do we really have now? How much choice do we need? How might health reform affect our choices? In some instances, do we have too much choice? How…

  • Study Finds Recent Slowdown in Health Spending Growth Mostly Tied to the Economy

    News Release

    Growth Expected To Move Towards Historical Levels In Coming Years As the Economy Recovers A new Kaiser Family Foundation analysis of how the economy affects the nation’s health spending concludes that the record slow growth rate of recent years stems largely from economic factors beyond the health system, with the economy explaining 77 percent of the slowdown, and more rapid growth expected in coming years if the economy strengthens as expected. Based on statistical modeling…

  • Oral Histories: Report from a Dental Fair

    Video

    This video profiles patients attending a dental fair in rural Virginia and highlights the impact of lack of coverage for oral health services. Uninsured adults have vast oral care needs, and untreated dental problems can have serious health, employment and social consequences.

  • Explaining Health Care Reform: Medical Loss Ratio (MLR)

    Fact Sheet

    This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and…

  • The Cost of Cancer

    Video

    This Kaiser Family Foundation documentary explores the financial consequences faced by three people, all privately insured, after being diagnosed with cancer. It was released in conjunction with a joint Kaiser/American Cancer Society report, "Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System." The Cost of Cancer: Tom Olszewski Tom Olszewski, a retiree who lives in Texas, had prostate cancer but has been in remission for a decade. His medical history made it…

  • Visualizing Health Policy: Health Care in the 2012 Election

    Other Post

    The October 2012 Visualizing Health Policy infographic provides a snapshot of how health care–related issues are shaping the 2012 presidential election, including the percentage of Democrats, Republicans, and independents who named health care or the economy as the issue that is most important in determining their vote for President; which health care issues are considered most important by Americans; how health care has compared with the economy and other issues as the most important issue…

  • ACA 101: What You Need to Know

    Event Date:
    Event

    Useful review for anyone seeking to comprehend complex issues leading up to major implementations taking effect in 2014

  • Questions for 2014

    From Drew Altman

    Today’s discussion of the Affordable Care Act (ACA) is focused on immediate implementation milestones leading up to 2014 when the law’s major provisions are set to kick in.  This is a critical period when the foundation for the ACA is being established and key building blocks such as the state Medicaid expansions, exchanges, and a host of regulations about other elements of the ACA being produced by HHS are getting our attention. But there is…