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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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  • The Part D Experience: What are the Lessons for Broader Medicare Reform?

    Event Date:
    Event

    Launched in 2006, Medicare added a prescription drug benefit that relies entirely on private plans, while, for other benefits, beneficiaries have a choice between private health plans and traditional fee-for-service Medicare. As policymakers consider changes to Medicare that would give an even greater role to private health plans in caring for Medicare’s nearly 50 million seniors and people with disabilities, the Kaiser Family Foundation hosted a policy workshop to examine how the Part D experience…

  • Health Care Use and Chronic Conditions Among Childless Adult Medicaid Enrollees in Arizona

    Issue Brief

    Under the Affordable Care Act (ACA), beginning in 2014, Medicaid eligibility will expand to 133% of the federal poverty level for nearly all individuals. Arizona is one of the few states that already cover adults without dependent children in Medicaid through a longstanding Section 1115 waiver. This report, based on 2007 Medicaid claims data for adult Medicaid enrollees in Arizona, provides an analysis of health care utilization and health conditions for childless adults and compares…

  • Understanding The Medicaid And CHIP Maintenance of Eligibility Requirements

    Fact Sheet

    This fact sheet examines the provisions in the Patient Protection and Affordable Care Act (ACA) that require states to maintain eligibility and enrollment standards for Medicaid and the Children's Health Insurance Program. These maintenance of eligibility (MOE) provisions were designed to keep Medicaid and CHIP coverage stable until coverage expands under the health reform law. Under the MOE provisions, to receive federal Medicaid funds, states cannot impose eligibility and enrollment policies that are more restrictive…

  • Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

    Fact Sheet

    State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states will be necessary to meet implementation timelines—exchanges must be fully operational by January 1, 2014 and the Department of Health and Human Services will begin…

  • Quick Take: Geographic Variation in Dual Eligible Enrollment

    Fact Sheet

    Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs.  These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).  Dual eligibles are among the sickest and poorest individuals covered by Medicare and Medicaid and, as a group, account for a disproportionate…

  • Behavioral Health: Can Primary Care Help Meet the Growing Need?

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    The health reform law has specific provisions covering mental health and substance use conditions, as well as general provisions to benefit those in need of behavioral health services. While addressing unmet needs, the reform law provisions raise new challenges. Given their budgetary constraints, will states be able to expand capacity to meet the demands of increased enrollment? Will sacrifices in other benefits and services be needed in order to provide mental health parity? Will the…

  • 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…

  • Public Opinion on Gender Rating

    Perspective

    With the Republican presidential primaries wrapping up, a barrage of new television commercials, radio ads, and fundraising emails has marked the start of the general election campaign. The Affordable Care Act (ACA) continues to be a mainstay election topic for candidates from both major parties. While Republicans focus on advocating repeal of the 2010 health care law, President Barack Obama and the Democratic Party have concentrated on the benefits of the law. And one lesser…

  • Five Key Questions About Medicaid And Its Role in State/Federal Budgets and Health Reform

    Report

    This fact sheet highlights key issues about Medicaid, including the structure, financing and purpose of the program, its role for low-income beneficiaries, its share of the federal budget and state budgets, and the significant implications of the coverage expansion under the Affordable Care Act. Fact Sheet (.pdf) Related chartpack: Five Key Questions And Answers About Medicaid