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The ACA MarketplaceS

What We Know about Trump’s $500 ACA Checks and the User Fees Funding Them

This analysis examines the $500 checks that the Trump administration is sending to some Affordable Care Act Marketplace enrollees and the user fees that are paying for them. The checks are going to about 1 million enrollees in the 30 states that rely on the federal HealthCare.gov Marketplace who are not receiving any tax credits this year.

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. The enrollment decline coincides with the expiration of the enhanced premium tax credits and other policy changes that are expected to reduce enrollment.

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Expanding Health Coverage for Low-Income Adults: Filling the Gaps in Medicaid Eligibility

    Issue Brief

    Low-income adults (those with incomes below 200 percent of poverty, or $33,200 for a family of three in 2007) account for just over half of the non-elderly uninsured in the United States. This brief reviews the health coverage of non-elderly low-income adults and discusses the implications for national health reform efforts of broadening coverage for this population by filling gaps in Medicaid eligibility. Low-income adults are more than twice as likely to be uninsured as…

  • Health Care Reform Newsmaker Series: Sen. Chris Dodd

    Event Date:
    Event

    This webcast captures an April 28, 2009 briefing with Sen. Chris Dodd (D-Conn.), senior member of the U.S. Senate Committee on Health, Education, Labor and Pensions. The briefing was part of the Health Care Reform Newsmaker series sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader…

  • Pulling it Together: 19.7

    Perspective

    Several years ago Joanne Silberner from NPR offered some advice I liked. Joanne said that the secret to effective communication was to "have a killer anecdote and a killer number." Here is a killer number: 19.7. That's the average number of years between major attempts at health reform since Harry Truman made health reform a top priority and his plan was branded a socialist plot and soundly defeated in 1950. The chart below chronicles the…

  • Health Care Reform Newsmaker Series: Nancy-Ann DeParle, Director of the White House Office of Health Reform

    Event Date:
    Event

    Nancy-Ann DeParle, director of the White House Office of Health Reform, appeared as the third guest in a series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session.  Transcript (.pdf) Video

  • The Public and the Health Care Delivery System — Summary and Chartpack

    Poll Finding

    This summary and chartpack of the results of a survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlight the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts –- including electronic medical records, coordination of care and comparative effectiveness –- all of which have become serious components…

  • April 2009 Health Tracking Poll

    Poll Finding

    The April Kaiser Health Tracking Poll finds that six in ten Americans continues to say that they or a member of their household have delayed or skipped health care in the past year. A solid majority of the public believes health care reform is more important than ever because of current economic problems. The country’s overall economic problems have not dampened their interest in pursuing health care reform: a solid majority of the public (59%)…

  • The Public and the Health Care Delivery System

    Poll Finding

    This survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlights the public’s attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans’ experiences with issues more typically discussed by health policy experts – including electronic medical records, coordination of care and comparative effectiveness – all of which have become serious components of reform plans and some of which have…

  • The Public and the Health Care Delivery System — Toplines

    Poll Finding

    These toplines from a survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlight the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts –- including electronic medical records, coordination of care and comparative effectiveness –- all of which have become serious components of reform plans and some…

  • Health Care Reform Newsmaker Series: Sen. Chuck Grassley (R-Iowa)

    Event Date:
    Event

    Sen. Chuck Grassley (R-Iowa), ranking Republican member of the Senate Committee on Finance, appeared as a guest in the new series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session.  Transcript (.pdf) Video

  • Health Care Reform Newsmaker Series: Sen. Max Baucus (D-Mont.)

    Event Date:
    Event

    Sen. Max Baucus (D-Mont.), chairman of the Senate Committee on Finance, appeared as the first guest in a new series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session. Transcript (.pdf) Video