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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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  • The Language of Health Care Reform

    Perspective

    Published in the Jan. 19 edition of JAMA, this article from KFF Executive Vice President for Health Policy Larry Levitt lays out the major health policy challenges that will confront President-elect Biden and potential approaches to major reform.While a big reform debate may not be likely this year, one is likely coming as the nation will need to confront much higher costs than in other high-income countries, worse outcomes in many cases, tens of millions…

  • A Status Report on Prescription Drug Policies and Proposals at the Start of the Biden Administration

    Issue Brief

    This brief provides a status update on prescription drug final rules advanced by the Trump Administration in its final months related to Medicare, importation, and 340B pricing for insulin and epinephrine, and an overview of key drug pricing proposals related to Medicare and prescription drug prices generally that were voted on but not enacted in the previous Congress that may return to the forefront of health policy discussions in the coming years.

  • ACA Open Enrollment Matters for Medicaid Coverage, Too

    Policy Watch

    President Biden’s January 28th executive order to reopen enrollment in the federal ACA Marketplace from February 15 through May 15, combined with $50 million in federal spending on outreach and education about ACA coverage options, has the potential to reach millions of people who were uninsured prior to or have lost coverage during the pandemic. As of 2019, there were 29 million non-elderly uninsured people, and the majority (57%) were eligible for financial assistance through…

  • How the COVID-19 Pandemic is Affecting People’s Mental Health and Substance Use

    News Release

    Throughout the COVID-19 pandemic and resulting economic crisis, about 4 in 10 adults nationwide have reported symptoms of anxiety or depressive disorder – a four-fold increase from pre-pandemic levels. Drawing on the latest national survey data, KFF polling and other research, an updated brief explores what’s known about the pandemic’s impact on people’s mental health and substance use and its implications for Americans’ well-being. Among the key conclusions:   • Young adults have been especially…

  • What to Expect During the COVID Marketplace Enrollment Period

    Policy Watch

    This post provides details about the ongoing Special Enrollment Period to sign up for health coverage on the ACA exchanges, including who is eligible to enroll, how costly Marketplace insurance is on average, and what other factors will affect enrollment during this period.

  • Drug Overdose Deaths Rose During the COVID-19 Pandemic, Particularly Among Black and American Indian/Alaska Native People

    News Release

    Drug overdose deaths rose during the early part of the COVID-19 pandemic, with some of the biggest jumps occurring among people of color, a new KFF analysis finds. The analysis breaks out drug overdose deaths by race and ethnicity for the first nine months of 2020, when the pandemic triggered widespread shutdowns and job losses, to the same period in each of the two prior years. Between 2018 and 2020, drug overdose death rates increased…

  • 10 Years of Hospital Readmissions Penalties

    Feature

    Over the 10-year lifetime of a Medicare program aimed at reducing hospital readmissions, 93% of eligible hospitals have been penalized at least once. Hospital readmissions have become less frequent, and most experts attribute that partly to the financial threat of the penalties, though other factors likely contributed to the improvements.