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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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  • Average Individual Mandate Penalty to Rise 47 Percent to $969 in 2016 for Uninsured People Eligible for ACA Plans

    News Release

     3.5 Million Could Have a Zero-Dollar Premium Contribution or Pay Less for Health Insurance than Penalty Due to Premium Subsidies; 7.1 Million Would Pay More to Get Coverage A new analysis from the Kaiser Family Foundation finds that among uninsured people who are eligible for an Affordable Care Act marketplace plan, the average penalty for remaining without coverage in 2016 would be $969 per household – 47 percent higher than the 2015 estimated average of $661.…

  • Bernie Sanders, Hillary Clinton, and Medicare for All

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explores the differing positions of presidential candidates Hillary Clinton and Bernie Sanders on a single payer or Medicare-for-all health care system and whether Democratic voters consider it an important factor in the 2016 primaries.

  • Bernie Sanders, Hillary Clinton, and Medicare for All

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores the differing positions of presidential candidates Hillary Clinton and Bernie Sanders on a single payer or Medicare-for-all health care system and whether Democratic voters consider it an important factor in the 2016 primaries. All previous columns by Drew Altman are online.

  • Surprise Medical Bills

    Issue Brief

    This brief explores the problem of "surprise medical bills" -- charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.

  • Will GOP Candidates’ Positions on Obamacare Matter in Crowded Field?

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman analyzes the politics of Republican Affordable Care Act replacement plans and the challenges all Republican candidates will face distinguishing themselves from others on the ACA in a crowded primary field. All previous columns by Drew Altman are available online.

  • Updated Infographic Explains New Federal Regulations on Contraceptive Coverage

    News Release

    A newly-updated infographic from the Kaiser Family Foundation explains the final regulations on employer-based coverage of birth control released today by the U.S. Department of Health & Human Services. How Does Where You Work Affect Your Contraceptive Coverage? provides a clear explanation of coverage requirements under the new regulations for employers with religious objections to contraceptive coverage, including houses of worship, religiously-affiliated nonprofits and closely-held for-profit corporations. A related summary, also updated to reflect the new regulations,…

  • Most Say They Can Afford Their Prescription Drugs, But One in Four Say Paying is Difficult, Including More Than Four in Ten People Who are Sick

    News Release

    Large Bipartisan Majorities Support Range of Policy Changes They Believe Would Curb Drug Costs Opinion on the Affordable Care Act Remains Largely Unchanged In August About half of Americans (54%) report currently taking a prescription drug, and a large majority of them (72%) say their prescriptions are very or somewhat easy to afford. However, about a quarter (24%) say paying for their drugs is difficult, and the share facing difficulties rises among those with low…

  • The California Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and the health care delivery system in California in the era of health reform.

  • Analysis Estimates 1 in 4 Employers Offering Health Benefits Could Be Affected by the ‘Cadillac Tax’ in 2018 if Current Trends Continue

    News Release

    Share of Potentially-Affected Employers Could Grow to 30% in 2023, 42% in 2028, Analysis Finds New projections from the Kaiser Family Foundation estimate that one in four employers (26%) offering health benefits could be subject to the Affordable Care Act’s tax on high-cost health plans, also known as the "Cadillac plan" tax, in 2018 unless they make changes to their plans. The analysis also estimates that the share of employers potentially affected by the tax…