Affordable Care Act

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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  • A Reporter’s Guide to Supreme Court Arguments on Health Reform

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation sponsored this reporters-only briefing to help journalists cover the Supreme Court arguments challenging the Patient Protection and Affordable Care Act and their aftermath with greater depth and understanding. Panelists focus on tips, story ideas and angles that have perhaps been underreported or overlooked, as well as angles for after the court ruling comes down, expected in June. The panel was co-moderated by Ed Howard…

  • Public Opinion on the ACA: Cruising or Turbulent Ride?

    Perspective

    Regular readers of the Kaiser Health Tracking poll know by now that public opinion on the Affordable Care Act (ACA) has been at a steady cruising altitude since it was signed into law on March 23, 2010, with a little over four in ten viewing the law favorably and a similar share unfavorably. But, has public opinion on the law since passage been more turbulent for different groups of Americans, for example, those with lower…

  • Kaiser Health Tracking Poll — March 2012

    Feature

    As the oral arguments on the Affordable Care Act (ACA) begin in two weeks before the Supreme Court, the March Kaiser Health Tracking Poll finds that Americans' views on the case mirror their views on the health reform law and that they expect parts of the ACA to continue whatever the Court rules. The poll finds that half of all Americans (51%) think the Court should rule the mandate unconstitutional and about the same number…

  • Americans’ Views on the Supreme Court Case Mirror Their Views on the Health Reform Law

    News Release

    The Public Expects Parts Of The Affordable Care Act To Continue Whatever The Court Rules Two Years After Passage The Public Is Evenly Divided On The Law, Split Sharply Along Partisan Lines MENLO PARK, Calif. -- The requirement that nearly everyone obtain health insurance or pay a fine has long been Americans’ least favorite part of the health reform law, and their views on what the Supreme Court should do about that key provision, known…

  • The ACA and Fluoridation: The Power of Political Symbols

    Perspective

    In the 1950s, water fluoridation became a public health controversy that morphed into a symbolic issue of larger proportions. For its opponents, fluoridation came to symbolize big government and even for some, a communist threat. The controversy became so odd that it was parodied in Stanley Kubrick’s 1964 film “Dr. Strangelove,” in which General Jack Ripper starts a nuclear war to stop a communist plot to “sap and impurify all of our precious bodily fluids”…

  • March Kaiser Health Tracking Poll: The ACA at Two Years; The Individual Mandate and the Supreme Court

    Perspective

    As the Patient Protection and Affordable Care Act (ACA) nears its second birthday, the latest Kaiser Health Tracking Poll finds that public opinion on the law remains evenly split (41 percent favorable, 40 percent unfavorable) with sharp divisions along partisan lines, much as it has been since the law was passed. With the Supreme Court preparing to hear challenges to the law later this month, about half the public thinks the Court should strike down the…

  • Health Insurance Transparency under the Affordable Care Act

    Perspective

    In February, a final rule was issued implementing the Affordable Care Act (ACA) requirement that all health plans provide a uniform summary of coverage for all enrollees and applicants. The idea of providing easy-to-understand summaries of coverage is, in fact, the most popular provision in the ACA, according to a recent Kaiser tracking poll. That finding suggests powerful consumer frustration over the complexity of health insurance and the difficulty people face evaluating health insurance choices and understanding…

  • Small Area Variations and the ACA’s Coverage Expansions

    From Drew Altman

    A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented.  It looks at how the benefits of the ACA's coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs).  PUMAs are artificial areas of about 100,000 people each created by the Census Bureau to provide more detailed demographic, social and economic information at the local level.  They…

  • Data Note: A Snapshot of Public Opinion on the Individual Mandate

    Poll Finding

    For the two years since the law's passage, and during the debate leading up to it, the individual mandate has been one of the most controversial aspects of the law. As the lawyers, policy makers, ACA opponents and supporters focus intently on the Supreme Court hearings, this Data Note looks at what the general public thinks of the mandate, explores the reasons why favorability ratings have been so low, and suggests that while opinion on…

  • Kaiser Health Tracking Poll — February 2012

    Feature

    In the midst of continuing debate on the future of the Medicare program, the February Kaiser Family Foundation Tracking Poll finds most Americans and most seniors favor the status quo, though arguments about the program’s solvency have the potential to sway opinion toward new proposals. The survey also gauges public opinion about the ongoing contraceptive coverage debate, views of the Affordable Care Act, and trust in the presidential candidates on health care issues. The February…