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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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  • Pathways to Payment Innovation in a Post-Health Reform Era

    Event Date:
    Event

    The new health reform law contains a number of changes in the way health care is paid for, particularly in public programs such as Medicare and Medicaid. The Alliance for Health Reform and The Commonwealth Fund sponsored a May 10 briefing which explored topics such as how some health care providers will be paid differently under reform, what effect this might have on payments across the health care system, and how providers are reacting. For…

  • What’s in There? The New Health Reform Law and Private Insurance

    Event Date:
    Event

    This briefing focuses on how the reform law affects access to private coverage, including the new federal high-risk pools, tax credits for small businesses, health insurance exchanges, the individual mandate and employer obligations. This briefing, cosponsored by the Alliance for Health Reform and the Kaiser Family Foundation, explored these and other issues. For more information, please visit Alliance's event page. Full Video    Speakers for this session: The panel is co-moderated by Diane Rowland of…

  • Summary of Key Changes to Medicare in 2010 Health Reform Law   

    Issue Brief

    Summary of Key Changes to Medicare in 2010 Health Reform Law . This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.

  • Explaining Health Reform: Medicare and the New Independent Payment Advisory Board

    Issue Brief

    This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while maintaining quality and access to care for beneficiaries. The board’s recommendations automatically take effect the next year unless Congress adopts an alternative plan to achieve…

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…

  • Health Care Reform and the CLASS Act

    Issue Brief

    This issue brief examines the Community Living Assistance Services and Supports (CLASS) program, a component of the health reform law that establishes a national, voluntary insurance program for purchasing community living services and supports that is designed to expand options for people who become functionally disabled and require long-term help. This brief describes the major components of the CLASS program including its financing, eligibility criteria, benefit design and interaction with Medicaid. Issue Brief (.pdf)

  • The New Health Reform Law and Medicaid

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    Event

    This briefing, cosponsored by the Alliance for Health Reform and the Kaiser Family Foundation, explores the provisions of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA). A panel of experts explain how PPACA and HCERA affect Medicaid, and answer questions about their Medicaid-specific provisions, including Medicaid eligibility, financing, and other implementation issues. For more information, please visit Alliance's event page. Full Video   Speakers…

  • Explaining Health Care Reform: Questions About Medicaid’s Role

    Issue Brief

    Medicaid plays a major role in covering more of the uninsured under the new health reform law. The new law includes a significant expansion of Medicaid, an individual requirement to obtain health insurance, and subsidies to help low-income individuals buy coverage through newly established Health Benefit Exchanges. This brief explains the how Medicaid works today and answers some key questions about Medicaid’s role in health reform. Issue Brief (.pdf)

  • Expanding Medicaid under Health Reform: A Look at Adults at or below 133% of Poverty

    Issue Brief

    This issue brief from the Kaiser Commission on Medicaid and the Uninsured examines the key characteristics of the 17.1 million low-income uninsured adults who currently have incomes that would qualify them for Medicaid under the expansion of the program in health reform. The planned expansion of Medicaid to all individuals with incomes at or below 133 percent of the federal poverty level will establish a national foundation of coverage based on income. Adults whose incomes…

  • Americans Remain Divided on Health Reform But Are Confused About The Law And How And When It Will Affect Them

    News Release

    Many Provisions That Take Effect in 2010 Are Popular and Have Bipartisan Support Cable News Tops List of the Public’s “Most Important” Information Sources MENLO PARK, Calif. –The first Kaiser Health Tracking Poll fielded since the passage of health reform last month finds that 8 in 10 Americans know that President Obama signed the legislation  into law.  But 55 percent say they are confused about the law and more than half (56%) say they don’t yet have…