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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  • Toplines: Kaiser Health Tracking Poll — August 2009

    Poll Finding

    This document contains the toplines from the August Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted August 4 through August 11, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 123 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Pulling it Together: This Could Be the Next Big Issue in Health Reform

    Perspective

    No, this is not about “death panels.” The town hall meetings.  The media coverage of the town hall meetings.  Media polls about how the American people feel about the town hall meetings.  And even the media myth busting and fact checking about the most extreme claims made at the town hall meetings and the Administration's daily efforts to set the record straight.  All these things have focused attention on a few hot button issues that…

  • How Will Uninsured Childless Adults Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured childless adults and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Children and Health Care Reform: Assuring Coverage That Meets Their Health Care Needs

    Issue Brief

    This issue brief examines the health care needs and health costs of children and analyzes the specific health care needs of two children in particular, including one with serious health challenges. The findings have implications for the health reform debate as policymakers consider minimum standards for coverage, required cost sharing amounts and limits on covered benefits in health plans. Issue Brief (.pdf)

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for their proposed high premium increases. The analysis shows that people buying health insurance on their own in the individual market…

  • Explaining Health Care Reform: Questions About the Extension of Dependent Coverage to Age 26

    Issue Brief

    The new health reform law requires private health insurers that offer dependent coverage to children to allow young adults up to age 26 to remain on their parent's insurance plan. This provision is among the first in the reform law to take effect, and it increases the availability of insurance to a population that currently has a high uninsured rate. This short summary answers basic questions about the dependent coverage expansion and explains how the…

  • The New Health Reform Law and Medicaid

    Event Date:
    Event

    This briefing, cosponsored by the Alliance for Health Reform and the Kaiser Family Foundation, explores the provisions of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA). A panel of experts explain how PPACA and HCERA affect Medicaid, and answer questions about their Medicaid-specific provisions, including Medicaid eligibility, financing, and other implementation issues. For more information, please visit Alliance's event page. Full Video   Speakers…

  • Full Steam Ahead: Implementation Opportunities and Challenges for Employers and Consumers

    Event Date:
    Event

    The new health reform law will significantly affect the way employers provide health coverage to their employees, and will transform many of the choices and protections consumers have in the marketplace. This briefing explored the major provisions in the law that relate to these changes. This September 8 briefing was cosponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation. For more information, please visit Alliance's event page. Full Video   Speakers…

  • Getting Connected: Can the ACA Improve Access to Health Care in Rural Communities?

    Event Date:
    Event

    Residents of rural communities face unique health care challenges, including fewer health care providers, higher rates of chronic disease, and lower adoption rates of health information technology. This October 13 briefing, cosponsored by the Alliance for Health Reform and the United Health Foundation, looked at the many provisions in the Patient Protection and Affordable Care Act (ACA) that speak to the needs of rural communities, with a focus on boosting the health care workforce and…

  • Rate Review: Spotlight on State Efforts to Make Health Insurance More Affordable

    Other Post

    The Patient Protection and Affordable Care Act creates a new federal role to examine “unreasonable increases” in the premiums charged for certain individual and small group health plans. Under the health reform law, the U.S. Department of Health and Human Services (HHS) will work with state insurance departments to conduct an annual review of unreasonable rate increases, and insurers must provide justification for such increases to HHS and to the public via their websites. The…