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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.

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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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  • Enrollment in the Individual Insurance Market Continued to Fall in the First Quarter of 2018, With the 12 Percent Overall Decline Concentrated in Off-Exchange Plans

    News Release

    Enrollment in the individual insurance market continued to shrink in the first quarter of 2018, declining by 12 percent compared to the first quarter of 2017, according to a new analysis from the Kaiser Family Foundation. The decline was concentrated in off-exchange plans where enrollees are not eligible for Affordable Care Act subsidies and have had to pay the full cost of recent premium increases. At the same time, enrollment in plans sold through the…

  • Compare Medicare-for-all and Public Plan Proposals

    Interactive

    This side-by-side interactive compares 10 bills to expand public health coverage through Medicare-for-All, a public option and other approaches, that have been introduced in the current Congress. The interactive allows users to compare these proposals across a number of dimensions, including eligibility, benefits, cost sharing, provider payments, and more.

  • Individual Market Enrollment Declined by 18% Since June 2025

    Individual Market Enrollment Continues to Fall Through Mid-2026

    Issue Brief

    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.

  • Key Issues in State Implementation of the New and Expanded Home and Community-Based Services Options Available Under the Affordable Care Act

    Issue Brief

    This brief summarizes the key issues identified and discussed by participants in Kaiser Family Foundation’s Commission on Medicaid and the Uninsured's July 16, 2013 roundtable meeting on state adoption of the new and expanded Affordable Care Act home and community-based services (HCBS) options. While states have made overall progress in rebalancing their long-term care systems in favor of community-based care, state adoption of ACA HCBS options has been relatively slow to date, despite the growing…

  • Helping Hands: A Look at State Consumer Assistance Programs under the Affordable Care Act

    Issue Brief

    Navigator and In-Person Assister programs created by the Affordable Care Act (ACA) will provide outreach and enrollment assistance during the open enrollment period for the new health insurance Marketplaces. This brief describes these programs, highlighting differences in how they are funded and structured and discusses some of the challenges they face.

  • How Buying Insurance Will Change Under Obamacare

    Perspective

    When the Affordable Care Act’s (ACA) health insurance marketplaces (also known as “exchanges”) go online this October, millions of people are expected to apply for private insurance coverage. Nobody expects the launch will be perfect, with no hitches and problems.  The law not only replaces a fragmented and confusing assortment of plan options in today’s individual insurance market, but it also integrates tax credits to help people pay their premiums, which requires an entirely new…

  • First Wave of Major New Survey Project on California’s Uninsured

    News Release

    California’s Uninsured Struggle With Costs and Access And Say They Want Insurance, But Most Have Heard Little About The Affordable Care Act, And Many Who Are Likely To Be Eligible For Medi-Cal or Exchange Subsidies Don’t Know It Many Undocumented Immigrants in CA Think They Will Get Coverage Through the ACA But Won’t Menlo Park, Calif. – California’s uninsured are skipping medical care, struggling with costs and want coverage, but many report knowing little about…

  • How Obamacare May Be Holding Down Costs

    From Drew Altman

    In his latest column published in Politico, Kaiser President and CEO Drew Altman examines the recent historic slowdown in health-care costs and discusses whether Obamacare is a contributing factor.