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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  • Side-by-Side Comparison of Major Health Care Reform Proposals

    Issue Brief

    On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, and a week later, signed into law the Health Care and Education Reconciliation Act of 2010, which made some changes to the comprehensive health reform law. Summary of Final Health Care Reform Law (.pdf) Download a printable comparison of the new health reform law (the Patient Protection and Affordable Care Act), the House-passed Health Care and Education Reconciliation Act…

  • An Introduction to Medicaid and CHIP Eligibility and Enrollment Performance Measures

    Issue Brief

    The Centers for Medicare & Medicaid Services (CMS) recently established 12 new Medicaid and CHIP eligibility and enrollment performance indicators for states to report beginning in October 2013. These indicators provide insight into the performance of new eligibility and enrollment policies established under the Affordable Care Act (ACA). In December 2013, CMS released initial reports for a subset of the indicators. This brief provides an overview of the new performance indicators; the initial data; and…

  • Key Findings from the Field: Early Experience with ACA Enrollment in Maryland and Nevada

    Issue Brief

    To learn more about the early ACA enrollment experience in two states, the Kaiser Commission on Medicaid and the Uninsured and PerryUndem Research and Communication conducted focus groups in Baltimore, Maryland and Reno, Nevada in November 2013 with low- and moderate-income individuals who recently applied for health insurance and consumer assisters trained to help individuals enroll. This study builds on previous work that examined preparations for open enrollment in several states, including Maryland and Nevada,…

  • Coverage for Abortion Services and the ACA

    Issue Brief

    This issue brief, Coverage of Abortion Services and the Affordable Care Act (ACA), summarizes the major coverage provisions of the ACA that are relevant for women of reproductive age, reviews current federal and state policies on Medicaid and insurance coverage of abortion services as they relate to the ACA, and presents national and state estimates on the availability of abortion coverage for women who are newly eligible for Medicaid or private coverage through the Marketplaces…

  • Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

    Issue Brief

    This brief explains three provisions of the Affordable Care Act (ACA) – risk adjustment, reinsurance, and risk corridors – that were intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform as the ACA marketplaces, also known as exchanges, were established.

  • Medicaid Enrollment Under the Affordable Care Act: Understanding the Numbers

    Issue Brief

    This issue brief walks through data recently released from Health and Human Services (HHS) and what it can and cannot tell us about the number of people that have applied for Medicaid since open enrollment for health insurance marketplaces began, how many have enrolled, and what the role of the ACA is in recent Medicaid coverage gains.

  • Health Reform Implementation Timeline

    Interactive

    The health reform implementation timeline is an interactive tool designed to explain how and when the provisions of the Affordable Care Act will be implemented over the next several years.

  • Americans Remain Split On Stalled Health Care Legislation, but Some Provisions Popular Among Majorities of Democrats, Independents and Republicans

    News Release

    Most See Delays As Driven By Politics Rather Than Policy MENLO PARK, CA – The latest Kaiser Tracking Poll finds the public still split on health care reform legislation, with 43 percent in favor and 43 percent opposed.  However, the poll also finds that majorities of Americans of all political leanings support several provisions in the health reform proposals in Congress and most attribute delays in passing the legislation to political gamesmanship rather than policy…

  • Mapping the Effects of the ACA’s Health Insurance Coverage Expansions

    Interactive

    The Foundation originally released this interactive tool in February 2012.  More recent analysis of the Affordable Care Act's potential impact on each state's uninsured population can be accessed through this interactive tool and these individual state reports. The Affordable Care Act includes several provisions that allow many individuals across the U.S. to be eligible for Medicaid or for federal tax credits to subsidize the cost of insurance. The analysis below and zip code tool estimate…