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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

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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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  • Kaiser Health Tracking Poll — March 2010

    Feature

    The March Kaiser Health Tracking Poll finds the public still divided on health reform legislation, with 46 percent of Americans backing the reform proposals on Capitol Hill, 42 percent opposing them and 12 percent saying they aren't sure. Six in 10 Americans say they have heard little or nothing about budget reconciliation. And many people continue to struggle with health costs, with nearly one in five saying cost increases have caused them or their employer…

  • Kaiser Health Tracking Poll: November 2012

    Feature

    The November poll finds that while health care ranked as a second-tier issue in this month's election, President Obama and Republican nominee Mitt Romney tied among voters who felt strongly about the Affordable Care Act, and President Obama won an advantage among voters who said Medicare was important to their vote, and among women on women’s health issues. The November poll is the latest in a series designed and analyzed by the Foundation's public opinion…

  • Kaiser Health Tracking Poll — May 2012

    Feature

    The May Health Tracking Poll focuses on the public's perceptions and reactions to women's reproductive health reemerging as a heated issue in policy debates and news and its potential impact on the upcoming presidential election. Three in ten women (31 percent) overall believe that there is currently a "wide-scale effort to limit women's reproductive health choices and services, such as abortion, family planning, and contraception" in the U.S. A larger share (45 percent) say there…

  • Medicaid Spending Growth over the Last Decade and the Great Recession, 2000-2009

    Report

    This report examines Medicaid spending growth nationally during the last decade, with a focus on growth during the recession of 2007 to 2009. The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been…

  • Kaiser Health Tracking Poll — December 2010

    Feature

    As 2010 draws to a close, the latest tracking poll shows the public still divided in their views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent have a generally unfavorable view of it. Seniors, generally more critical of the law than younger people, seem to be softening in their opposition as…

  • Alternatives for Financing Medicaid Expansions in Health Reform

    Report

    Expanding Medicaid to cover low-income populations has been a fundamental component of leading health reform proposals. The House Leadership Bill would expand Medicaid to 150 percent of the federal poverty level and the Senate Leadership Bill would expand Medicaid to 133 percent of the federal poverty level. In both scenarios the federal government would finance a substantial share of costs for the expansion groups.  This analysis, however, shows that it is possible to distribute increased…

  • My husband would like to get a vasectomy, but when I checked with our insurer, they told me that the plan would cover my sterilization without cost-sharing, but we would have to pay part of the costs fo...

    FAQs

    The ACA requires most private health plans to cover birth control, including sterilization, for women, but they are not required to cover sterilization (vasectomies) for men. However, nine states (CA, IL, MD, NJ, NM, NY, OR, VT, and WA) require certain health plans in those states to cover vasectomies, at no cost to the patient. Check with your insurance plan or state insurance department for more information.

  • ¿Me pueden cobrar primas más altas en el mercado si fumo? ¿Cuentan los cigarrillos electrónicos?

    FAQs

    En la mayoría de los estados, sí. Generalmente, una aseguradora puede cobrarle hasta un 50% más si ha consumido productos de tabaco cuatro o más veces por semana en promedio durante los últimos 6 meses. Esto se denomina recargo por tabaco. Por ejemplo, si la prima para alguien de su edad (antes de aplicar los subsidios) fuera de $200 al mes, si usted consume tabaco, su prima podría aumentar a $300 al mes. Las normas…