Affordable Care Act

The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Quality Care for Less Money: Can Regional Successes Go National?

    Event Date:
    Event

    On February 15, the Kaiser Family Foundation hosted an event featuring a PBS documentary with former Washington Post correspondent T.R. Reid – U.S. Health Care: The Good News – which explores efforts to provide low-cost, quality health care in the U.S. The film looks at variations in health spending across the country and showcases efficient health care delivery systems, like Grand Junction in Colorado and Group Health in Seattle, suggesting that these communities demonstrate that…

  • The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments

    Issue Brief

    One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law's Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at or below 133% of the federal poverty level as of January 2014. A ruling on the Medicaid expansion could have far-reaching impacts on the present…

  • Quick Take: An Update on the ACA & HIV: Medicaid Health Homes

    Fact Sheet

    We recently wrote about the different ways in which the Affordable Care Act (ACA) changes pathways to health insurance coverage for people with HIV, and chronicled these specifics, as well as several outstanding questions, in a policy brief.  As we noted, among the many provisions of the ACA designed to improve care is a new option available to state Medicaid programs to provide “health homes” for Medicaid enrollees with chronic conditions, with a temporary enhanced…

  • Pulling it Together: Implementation

    Perspective

    When I was a graduate student at MIT my adviser Jeffrey Pressman was a great political scientist who had just written the seminal book on program implementation.  It was called, simply enough, Implementation, with a subhead that read: "how great expectations in Washington are dashed" (OK, we political scientists study politics too much and are a little cynical at times).  The book literally created a new subfield in political science focusing on program implementation.  This…

  • Briefing Examines High Medicare Spending for Beneficiaries in Long-Term Care

    Event Date:
    Event

    These three reports examine the relatively high use of hospital and other Medicare-covered services and the associated costs of medical care for Medicare beneficiaries who live in nursing homes and other long-term-care facilities. They also explore the potential for delivery system reforms to improve quality and reduce costs. Medicare Spending and Use of Medical Services for Beneficiaries in Nursing Homes and Other Long-Term Care Facilities: A Potential for Achieving Medicare Savings and Improving the Quality…

  • A Medicaid Block Grant Would Reduce Federal Spending But Trigger Substantial Cuts in Medicaid Coverage in the States That Would Increase the Uninsured

    News Release

    NEWS RELEASEMay 10, 2011 New State-By-State Analysis Shows House Budget Plan For Medicaid Would Reduce Enrollment By Tens of Millions Of People And Cut Funding For Hospitals And Other Medicaid Services WASHINGTON, D.C. -- Converting Medicaid into a block grant and repealing the health reform law as adopted by the House last month in a party-line vote would trigger major reductions in program spending and enrollment compared to current projections, a shift with big implications…

  • The Massachusetts Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Massachusetts health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

    Fact Sheet

    State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states will be necessary to meet implementation timelines—exchanges must be fully operational by January 1, 2014 and the Department of Health and Human Services will begin…

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…

  • The Symbolic Manipulation of Health Issues in Elections

    From Drew Altman

    KFF President and CEO Drew Altman explains why data and facts, policy plans and lists of accomplishments do not connect with many voters. Understanding the symbolic dimensions of politics and issues is critical for experts. We can reach a share of the public with facts and data but need additional strategies to reach everyone, including storytelling and trusted messengers.