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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

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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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  • Analysis: Most Short-Term Health Plans Don’t Cover Drug Treatment or Prescription Drugs, and None Cover Maternity Care

    News Release

    A new Kaiser Family Foundation analysis of short-term, limited duration health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper alternative to individual market plans that comply with the Affordable Care Act’s requirements. Repeal of the individual mandate penalty – which…

  • I notice something called “Easy pricing” under the plan name on HealthCare.gov. What does that mean?

    FAQs

    "Easy pricing" refers to a "standardized" plan design on HealthCare.gov that aims to make it simpler to compare plans by applying the same to each category of essential health benefits across all easy pricing plans in the same metal level. For example, all Bronze-level easy pricing plans have the same deductible and copays. By contrast, non-standardized Bronze-level plans might have different deductible and copay amounts. Easy pricing plans are marked with a green circle with…

  • The Average Marketplace Deductible Grew by About $1,000 Per Person in 2026, With More Enrollees Shifting to Higher-Deductible Plans as Enhanced Tax Credits Expired

    News Release

    The average Affordable Care Act (ACA) Marketplace deductible experienced the steepest increase in history—growing by 37% or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired, according to a new KFF analysis. After the enhanced tax credits ended, many Marketplace shoppers shifted toward lower-premium, higher-deductible plans.

  • In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

    News Release

    ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

  • Eight Trends Shaping 2026 Health Care Costs

    Other Post

    A new Peterson-KFF policy explainer lays out the health care trends shaping the 2026 policy debates, including rising premiums, spending on prescription drugs, health care price transparency and consolidation, artificial intelligence in health care, Medicaid funding cuts and other key program changes.

  • How Unaffordable is Health Care?

    Perspective

    In his latest JAMA Forum column, KFF’s Larry Levitt explores how unaffordable health care is in the U.S. in the context of the debate over extending enhanced Affordable Care Act premium tax credits and an upcoming election where affordability will likely be front and center.

  • Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

    Poll Finding

    This KFF survey is a follow-up survey of adults who had ACA Marketplace insurance in 2025. The survey examines the cost concerns and coverage changes that these 2025 Marketplace enrollees are experiencing following the expiration of the enhanced premium tax credits. The survey finds that half of returning enrollees say their health care costs are “a lot higher” and most expect to cut back on basic household expenses to afford coverage.

  • ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

    Quick Insights

    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…

  • What We Know So Far About 2026 ACA Marketplace Enrollment, Premiums, and Deductibles

    Issue Brief

    This analysis examines early indicators of how the expiration of enhanced premium tax credits has affected effectuated enrollment levels (i.e., enrollment among people who have paid their premiums), plan selections, and out-of-pocket costs in 2026, drawing on plan selection and effectuated enrollment data from the Centers for Medicare & Medicaid Services (CMS) and state-based Marketplace (SBM) Open Enrollment reports, as well as KFF survey data and individual market enrollment estimates from Wakely Consulting Group.