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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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  • Is it Too Late for ACA Insurers to Change Their Premiums?

    Quick Insights

    Affordable Care Act Marketplace insurers are raising premiums by an average of 18% next year, due in part to the expiring enhanced premium tax credits. Even if the credits are extended in shutdown negotiations, it is unlikely that insurers will have time to revise premiums, though the credits would still offer enrollees relief from them.

  • A Steep Subsidy Cliff Looms for Older Middle-Income Enrollees if ACA Enhanced Tax Credits Expire

    Quick Insights

    The expiration of the ACA enhanced premium tax credits at the end of this year would reintroduce the “subsidy cliff,” which abruptly ends the credit for Marketplace enrollees earning over 400% of poverty. That means some middle-income enrollees, especially older ones, would spend a much larger share of their income on premium payments than those earning just slightly less with the credit.

  • Navigating Uncertainty: The Latest Challenge to the Title X Family Planning Safety Net

    Quick Insights

    The Administration's latest funding deadline and guidance shift intensifies pressure to the reproductive health safety net at a time when the number of uninsured individuals is projected to rise due to Medicaid cuts and expiration of enhanced Affordable Care Act premium tax credits, and Planned Parenthood clinics have lost their federal Medicaid funding.

  • After 16 Years, Partisans Still View the Affordable Care Act Very Differently

    Quick Insights

    On the 16th anniversary of the Affordable Care Act’s (ACA) passage, most of the public (61%) view the law favorably, though opinions and debates remain as partisan as ever....As voters continue to grapple with the affordability of coverage and care, the partisan legacy of the ACA will almost certainly figure into debates about health care costs this fall.

  • Grandfathering Explained

    Perspective

    The Republican leadership in the House of Representatives recently indicated that it will be seeking to repeal regulations under the Affordable Care Act (ACA) that govern the “grandfathered” status of health plans. As this aspect of the health reform law gets more scrutiny, it may be useful to review some of the specifics of how grandfathering works. The purpose of grandfathering: As provisions of the ACA go into effect, grandfathering provides for a smoother transition by…