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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.

About the ACA

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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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  • I estimate my income next year will be very low, so I need my premium tax credit all paid in advance. If, by the end of the year, it turns out my annual income was even lower than I expected and I could...

    FAQs

    No, your final premium tax credit amount will be determined based on your income for the year as reported on your tax return. The fact that it ended up being less than you expected does not mean you have to repay the advance premium tax credit paid on your behalf, even if you could have qualified for Medicaid. In fact, your final credit amount will likely be larger than the amount you received in advance.…

  • Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?

    FAQs

    Yes. Many insurers that offer plans through the ACA Marketplace also offer identical plans outside of the Marketplace that meet all ACA standards, although premium tax credits and cost-sharing subsidies are not available for plans sold outside of the Marketplace. Some people prefer to buy health insurance outside of the Marketplace when they are sure they won’t qualify for financial assistance. Like health insurance plans sold on the Marketplace, “ACA-compliant” plans sold outside of the…

  • I received a Form 1095-C in the mail. What’s that?

    FAQs

    Form 1095-C will indicate your name and the name of your employer, the months when you were eligible for coverage, and the cost to you of the cheapest monthly premium you could have enrolled in under your employer’s health plan. If you worked for a large employer that did not offer its full-time employees health coverage, Form 1095-C will also indicate that. Keep this form with your tax records. You may need this form if…

  • ¿Qué es el formulario 8962?

    FAQs

    Si recibió un subsidio anticipado para pagar las primas (APTC) a través del mercado el año pasado, debe presentar un formulario 8962 con su declaración de impuestos federal para conciliar sus ingresos estimados y reales del año, incluso si calculó sus ingresos con precisión. Puede obtener un formulario 8962 en blanco en el sitio web del IRS o, si utiliza un software de preparación de impuestos, el formulario se generará automáticamente. Las instrucciones del formulario…

  • Escuché que los planes de salud tienen que cubrir servicios sin costos compartidos. ¿Esto incluye a todos los servicios preventivos? ¿Hay límites o excepciones a lo que cubren?

    FAQs

    La mayoría de los planes de salud, incluidos los del mercado de seguros, deben cubrir una amplia gama de servicios preventivos y no pueden imponer costos compartidos (como deducibles, copagos o coaseguros). La Ley de Cuidado de Salud a Bajo Precio (ACA) exige que los planes privados cubran servicios en cuatro categorías generales: Exámenes y asesoramiento basados ​​en la evidencia Vacunas de rutina Servicios preventivos infantiles Servicios preventivos para mujeres Siempre que el servicio preventivo…

  • The Implications of COVID-19 for Mental Health and Substance Use

    Issue Brief

    This brief explores mental health and substance use during, and prior to, the COVID-19 pandemic. We highlight populations that were more likely to experience worse mental health and substance use outcomes during the pandemic and discuss some innovations in the delivery of services.

  • Survey of Health Insurance Marketplace Assister Programs

    Report

    This survey by the Kaiser Family Foundation of Navigators and other Marketplace consumer assistance programs under the Affordable Care Act (Obamacare) offers a nationwide analysis of the number and distribution of assisters and people they helped. The report examines the experience of programs in conducting outreach and enrollment assistance during the first open enrollment period. It also reviews the nature of help consumers needed applying for Medicaid or premium tax credits and understanding health insurance…

  • Medical Debt Among Insured Consumers: The Role of Cost Sharing, Transparency, and Consumer Assistance

    Perspective

    This policy insight examines medical debt among insured consumers, exploring how high cost sharing in health insurance plans can contribute, and explaining how greater transparency could help consumers avoid some financial pitfalls. It also provides an update on provisions of the Affordable Care Act meant to increase health plan transparency and bolster consumer assistance.

  • Costly GLP-1 Drugs are Rarely Covered for Weight Loss by Marketplace Plans

    News Release

    Affordable Care Act (ACA) Marketplace plans rarely cover GLP-1 drugs approved solely for obesity treatment, according to a new KFF analysis of 2024 federal plan data. Wegovy, a drug that is approved for weight loss, is covered by just 1% of Marketplace prescription drug plans, compared to 82% of Marketplace prescription drug plans for Ozempic, which contains the same active ingredient as Wegovy (semaglutide) but is approved only for diabetes. When GLP-1 drugs are covered…