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Affordable Care Act

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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 — February 2009

    Poll Finding

    The first Kaiser Health Tracking Poll of 2009 finds the public is increasingly worried about the affordability and availability of care, with many postponing or skipping treatments due to cost in the past year and a notable minority forced into serious financial straits due to medical bills. Slightly more than half (53%) of Americans say their household cut back on health care due to cost concerns in the past 12 months. The most common actions…

  • Health Affairs Article: Beyond Incrementalism? SCHIP and the Politics of Health Reform

    Report

    This article examines the political and legislative history of the Children's Health Insurance Program and analyzes the lessons for policymakers who are contemplating broader health care reform. It was published online in the journal Health Affairs and was authored by Jonathan Oberlander, an associate professor, social medicine and health policy and management, at the University of North Carolina at Chapel Hill, and Barbara Lyons, a vice president of the Kaiser Family Foundation and deputy director…

  • Making Health Care Work for American Families: Medicaid and Access to Care

    Event Date:
    Event

    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Foundation's Commission on Medicaid and the Uninsured, testified March 24, 2009, before the House Energy and Commerce Subcommittee on Health as part of a hearing entitled “Making Health Care Work for American Families: Access to Care." Rowland, appearing as part of a panel, addressed why Medicaid can be a platform for health care reform and can be instrumental in efforts…

  • The Public and the Health Care Delivery System — Toplines

    Poll Finding

    These toplines from a survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlight the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts –- including electronic medical records, coordination of care and comparative effectiveness –- all of which have become serious components of reform plans and some…

  • Pulling it Together: The Health Care Industry’s Second Voluntary Effort

    Perspective

    The announcement that health care industry groups plan to put on the table voluntarily a package of proposals to shave $2 trillion off the rate of increase in health spending over the next ten years immediately conjures up the image of the Voluntary Effort or VE launched with similar fanfare in the Carter administration.  Back then the industry used the VE to fend off Jimmy Carter's efforts to aggressively control the costs of hospital care…

  • In Depth Analysis of Health Reform Issues

    Report

    These reports provide in-depth analysis related to the health reform debate. Additional reports will be added as they become available. Medicaid Expansion in Health Reform: National and State Estimates of Coverage and CostsThis analysis and public briefing examine the potential national and state-by-state impacts on Medicaid enrollment and spending of the expansion of coverage for low-income adults under the health reform law. Reform Calculator Estimates Premiums and Subsidies Available In 2014The Foundation's interactive health reform…

  • Explaining Health Care Reform: What is Health Insurance?

    Issue Brief

    A key element in any comprehensive health reform plan is defining what health insurance is and the amount of insurance coverage people will have. There are two components to that coverage: the types of services covered (e.g., physician care, hospitalization, prescription drugs, etc.), and the cost sharing required of enrollees (e.g., the annual deductible, the copayments or coinsurance, and the maximum out-of-pocket costs for a year). The overall approach to reform drives the kinds of…

  • Data Note: Footing the Bill

    Poll Finding

    This brief data note looks at the raft of polls recently released on the public’s willingness to pay for an expansion of coverage to their fellow citizens. It compares and contrasts findings on Americans’ general inclinations on the topic, and also revisits recent findings on specific revenue raising proposals. Data Note (.pdf)

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • Testimony: State-Based Health Reform Efforts

    Event

    On June 16, 2008, Kaiser Family Foundation Vice President Gary Claxton testified about state-based health reform efforts as part of the Senate Finance Committee's Preparing For Launch Health Reform Summit. In his prepared testimony, he examined the role of Medicaid and the State Children's Health Insurance Program, as well as the way various federal laws and policies may limit innovation at the state level. Testimony (.pdf)