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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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  • Already at Record High, ACA Marketplace Enrollment Could Increase Further

    News Release

    Enhanced Marketplace subsidies have continued to drive up enrollment in the individual market, and the loss of Medicaid coverage by millions of people could contribute to this trend, according to a new KFF analysis. Meanwhile, enrollment in non-ACA-compliant plans is at a record low. As of early 2023, an estimated 18.2 million people have individual market coverage, the highest since 2016. Individual market enrollment grew by about 29% between early 2020 and early 2023 —…

  • Testimony: Tax-Exempt Hospitals and the Community Benefit Standard

    Issue Brief

    Zachary Levinson, Project Director of KFF’s Program on Medicare Policy, testified before the U.S. House of Representatives’ Committee on Ways and Means on April 26, 2023 as part of a hearing on Tax-Exempt Hospitals and the Community Benefit Standard.

  • Private Insurers Expect to Pay $1.1 Billion in Rebates This Year for Setting Premiums Too High Relative to Medical Costs

    News Release

    Private insurance companies are expecting to pay out about $1.1 billion in rebates this fall under an Affordable Care Act (ACA) provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three years. This year’s estimated total is similar to the $1 billion paid out last year, but well short of the $2.5 billion record total paid…

  • Use of ACA preventive services potentially affected by Braidwood v. Becerra

    Issue Brief

    This analysis finds that about 10 million privately insured people received at least one ACA preventive service or drug that could be affected by a now-stayed U.S. District Court ruling, which found the Affordable Care Act's (ACA) requirement to cover certain preventive services without any cost sharing to be partially unconstitutional.

  • About 1 in 20 People with Private Insurance Received Services that Could be Affected by a District Court Ruling Limiting the ACA’s Preventive Services Mandate

    News Release

    A new KFF analysis finds about 1 in 20 privately insured people (5.7%) received at least one ACA preventive service or drug that could be affected by a now-stayed U.S. District Court ruling in Braidwood Management v. Becerra, which found the Affordable Care Act’s (ACA) preventive services mandate partially unconstitutional. The district court also found that pre-exposure prophylaxis (PrEP), medication recommended for HIV prevention, violates the religious rights of those who have objections to its…

  • KFF Survey of Consumer Experiences with Health Insurance

    Poll Finding

    The survey finds nearly six in 10 people with health insurance experienced a problem using their insurance in the past year, with even larger shares reporting problems among people who are sick or who have mental health needs. It includes data for people with different types of coverage, including employer, Marketplace, Medicare and Medicaid, and also examines affordability issues and mental health access.

  • One Year Since Dobbs: The Landscape of Abortion Policies Across the US  

    News Release

    There has been intense focus on abortion policies across the United States since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization on June 24, 2022. That decision overturned Roe v. Wade, eliminating federal constitutional protections for abortion and putting the decision to restrict or protect abortion with the states.  Now, nearly one year later, what is the status of federal and state developments? Where is abortion banned? Where is litigation pending? And…

  • Health Care Issues in the Early Stages of the 2024 Election

    Perspective

    In this JAMA Health Forum column, Larry Levitt examines differences in the Republican presidential candidates’ records and positions on health issues, including Medicaid and abortion, that could play a role in the primaries and would set up a sharp contrast in the general election against President Biden.

  • Medicaid Expansion Has Had Beneficial Effects on Some Sexual and Reproductive Health Outcomes 

    News Release

    A new KFF review of more than three dozen studies published between April 2021 and June 2023 finds that Medicaid expansion under the Affordable Care Act is associated with beneficial effects on a range of sexual and reproductive health outcomes. The studies, which echo findings of previous research, find that Medicaid expansion is associated with increased health insurance coverage prior to and after pregnancy, as well as increased access to, and utilization of, both prenatal…