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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 Uninsured and the ACA: A Primer – Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act

    Report

    The Uninsured and the ACA: A Primer provides information on how insurance has changed under the ACA and more recent policy changes, how many people remain uninsured, who they are, and why they lack health coverage. It also summarizes what we know about the impact that a lack of insurance can have on the health outcomes and personal finances and the difference health insurance can make in people’s lives.

  • The Health Care Priorities and Experiences of California Residents

    Report

    This survey by the Kaiser Family Foundation and California Health Care Foundation gauges California residents’ views on health care priorities facing the state’s new governor and legislature, including health care affordability, access to care, mental health and substance use treatment, and provider shortages. It also highlights Californians’ experiences in the health care system, as well as views on the Affordable Care Act, Covered California, Medi-Cal, and proposals to advance a single-payer health insurance system in…

  • Testimony: Pre-Existing Conditions and Health Insurance

    Issue Brief

    KFF's Karen Pollitz testimony before the U.S. House Committee on Ways and Means on Jan. 29, 2019 examines the prevalence of pre-existing conditions, the impact of the Affordable Care Act's prohibition against medical underwriting and other provisions aimed at stabilizing the insurance risk pool, and the trade-offs involved in relaxing those provisions. 

  • How Repeal of the Individual Mandate and Expansion of Loosely Regulated Plans are Affecting 2019 Premiums

    Issue Brief

    In health insurance systems designed to protect people with pre-existing conditions and guarantee availability of coverage regardless of health status, countervailing measures are also needed to ensure people do not wait until they are sick to sign up for coverage (as doing so would drive up average costs for other enrollees). The Affordable Care Act (ACA) included a variety of “carrots” (e.g., premium tax credits and cost-sharing reductions) and “sticks” (e.g., the individual mandate penalty…

  • Health Care and the Candidates in the 2018 Midterm Elections: Key Issues and Races

    Issue Brief

    Introduction With the 2018 midterm election season in full swing, health care has emerged as one of the top issues for voters. The issue is playing a prominent role in many House, Senate, and gubernatorial races, and health-related measures have made it onto the ballot in several states. Democratic candidates, in particular, have made health care a central part of their campaigns and a focus of their political ads, highlighting popular provisions in the Affordable…

  • The Role Health Is and Is Not Playing in the Midterms

    From Drew Altman

    With less than two weeks until Election Day, Drew Altman discusses health being the top issue, but not necessarily the top factor in voters' 2018 decisions. He says the longer-term impact of health may be its continuing role in the debate leading up to the 2020 presidential race.