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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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  • President Trump’s Record on Health Care

    Issue Brief

    This issue brief provides a detailed overview of the Trump Administration’s record on health care issues relating to: the Administration’s response to the COVID-19 pandemic, the ACA and private insurance markets, Medicaid, Medicare, reducing prescription drug and other health care costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.

  • From the Federal Response to COVID-19 to Ongoing Efforts to Repeal the ACA and Proposals for Lowering Drug Prices, President Trump Has an Extensive Record on Health Care

    News Release

    Since taking office in 2017, President Trump has laid down an extensive record on health care, including his response to the COVID-19 pandemic, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency. President Trump’s record on health care provides a window into…

  • Is COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned

    Policy Watch

    If the ACA is overturned, federal law protection for people with pre-existing health conditions would end.  This post examines what that could mean for people in the time of COVID-19, including whether and how insurers could deny coverage to people who have had COVID or other pre-existing conditions.

  • A Court Ruling Striking Down the ACA Would Eliminate the Medicaid Expansion and Cause Millions of Low-Income People to Become Uninsured

    News Release

    Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November, KFF experts explain in a new Policy Watch post. Overturning the ACA would eliminate the expansion of Medicaid, which largely has been financed by the federal government, and eliminate eligibility for Medicaid for low-income…

  • The ACA Family Glitch and Affordability of Employer Coverage

    Issue Brief

    This analysis estimates that 5.1 million people fall into the Affordable Care Act's "family glitch," which occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. It explores the demographic characteristics of this group, including state-level estimates.

  • Analysis Estimates 5.1 Million People Fall into the Affordable Care Act’s “Family Glitch”

    News Release

    A new KFF analysis estimates 5.1 million people nationally fall into the Affordable Care Act’s “family glitch” that occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. The so-called glitch occurs because the ACA prohibits people with an offer of affordable employer coverage from purchasing subsidized coverage through the ACA marketplace. Under current rules, the affordability of…

  • Private Insurers Are Expected to Pay $2.1 Billion in Rebates to Consumers This Year for Excessive Health Insurance Premiums Relative to Health Care Expenses

    News Release

    Private insurance companies are expecting to pay out $2.1 billion in rebates to consumers this fall, the second highest amount ever issued under the Affordable Care Act, according to a new KFF analysis. The rebates, which are calculated based on the share of premium revenues that insurance companies paid out for health care expenses and quality improvement, are roughly $400 million lower than last year’s record high of $2.5 billion, but more than 50 percent…

  • Health Spending for 60-64 Year Olds Would Be Lower Under Medicare Than Under Large Employer Plans

    Issue Brief

    During the presidential campaign, President Biden proposed to lower the age of Medicare eligibility from 65 to 60. This analysis uses claims data for covered medical services from both large employer plans and traditional Medicare to illustrate the potential spending effects of using Medicare payment rates in lieu of higher rates paid by employer plans for people 60-64 who shift from large employer plans to Medicare.