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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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  • Uninsured Young Adults: A Profile and Overview of Coverage Options

    Issue Brief

    Young adults, age 19-29, have the highest uninsured rate of any age group. Since 29% of the uninsured are young adults, efforts to decrease the overall number of uninsured must address this population. This brief examines health coverage for young adults, as well as their health status, access to care, and the financial burdens they encounter when paying for care. It also provides an overview of public and private approaches to expand health coverage for…

  • Testimony: State-Based Health Reform Efforts

    Event

    On June 16, 2008, Kaiser Family Foundation Vice President Gary Claxton testified about state-based health reform efforts as part of the Senate Finance Committee's Preparing For Launch Health Reform Summit. In his prepared testimony, he examined the role of Medicaid and the State Children's Health Insurance Program, as well as the way various federal laws and policies may limit innovation at the state level. Testimony (.pdf)

  • Addressing Disparities in Health and Health Care — Issues for Reform

    Event

    Marsha Lillie-Blanton, Dr.P.H., Kaiser senior advisor on race, ethnicity and health care, testified before the House Ways and Means Health Subcommittee about the role of health insurance in reducing disparities in health care and in health status. The testimony is part of an ongoing health reform hearing series. Testimony (.pdf) Slides (.ppt)

  • Pulling It Together: Health IN the Economy

    Perspective

    I am writing this Pulling It Together column about this one chart and its potential interpretations and implications. Source: Key Findings: Kaiser Health Tracking Poll: Election 2008 -- April 2008, Kaiser Family Foundation, April 2008. This chart from our most recent tracking poll shows the economy rising as a political issue and health care falling, with Iraq in the middle. Findings from other polling groups will show the same thing for as long as the economy…

  • Survey Brief: Economic Problems Facing Families

    Poll Finding

    This poll finds that health care costs rank among Americans’ top personal economic problems, and their struggles to deal with those costs have affected both their financial well-being and their family’s health care. Conducted by the Foundation’s public opinion researchers, the poll probes into the economic concerns facing Americans and the ways they have dealt with the cost of health care. The poll was designed and analyzed by public opinion researchers at the Kaiser Family…

  • Kaiser Health Tracking Poll: Election 2008 — April 2008

    Poll Finding

    An April 2008 poll finds that health care costs rank among Americans’ top personal economic problems, and their struggles to deal with those costs have affected both their financial well-being and their family’s health care.  Conducted by the Foundation’s public opinion researchers, the poll probes into the economic concerns facing Americans and the ways they have dealt with the cost of health care. Across a series of economic concerns, health care costs rank near the…

  • New Analysis Shows Effect of Rising Unemployment on Health Coverage, Medicaid and SCHIP Spending and Enrollment

    Event

    As the country faces another economic downturn, many states are scrambling to deal with the impact of poor economic conditions on programs, like Medicaid and the State Children’s Health Insurance Program (SCHIP), that are reliant on state funding. To be better able to cope, states are looking for fiscal relief from the federal government as well as obtaining a moratorium on federal regulations that would reduce Medicaid funding for states from the Congress. New analyses…

  • How Private Health Coverage Works: A Primer – 2008 Update

    Issue Brief

    How Private Health Coverage Works: A Primer— 2008 Update This primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations that operate under the federal Employee Retirement Income Security Act (ERISA). The primer discusses the fundamental aims of private health coverage and sorts out…

  • Health Care Affordability and the Uninsured

    Event

    Diane Rowland testified at a hearing on the instability of health coverage before the Health Subcommittee of the U.S. House Committee on Ways and Means. Her testimony discussed the growing share of Americans who are uninsured and without adequate health insurance coverage and highlighted the key characteristics and issues with regard to the uninsured as well as the financial burdens for medical care faced by America's families. Testimony (.pdf)

  • Health Affairs Article: Comparing the Assets of Uninsured Households to Cost Sharing Under High Deductible Health Plans

    Issue Brief

    Health Affairs Article: Comparing the Assets of Uninsured Households to Cost Sharing Under High Deductible Health Plans Relatively few uninsured households have enough financial assets to cover the cost-sharing in consumer-driven health plans tied to Health Savings Accounts (HSAs), according to this study by Kaiser Family Foundation researchers published as a Health Affairs Web Exclusive on April 15, 2008. Consumer-driven plans generally require enrollees to pay for most health-care expenses themselves until they reach the plan’s relatively high…