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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.

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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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  • ¿Qué pasa si termino necesitando atención de un doctor que está fuera de la red de mi plan?

    FAQs

    Los planes no están obligados a cubrir la atención recibida de un proveedor que no pertenece a la red, aunque algunos planes del mercado lo hacen, al menos en cierta medida. Si recibe atención fuera de la red, podría ser costoso para usted. En general, los planes que brindan una opción fuera de la red cubren dicha atención a una tasa más baja (por ejemplo, se puede reembolsar el 80% de los costos dentro de…

  • Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act

    Policy Watch

    As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy…

  • Compré anticonceptivos de emergencia de venta libre en mi farmacia y pensé que mi seguro los cubriría, pero terminé teniendo que pagar el costo total de mi bolsillo. ¿Por qué no lo cubre mi seguro?

    FAQs

    La anticoncepción de emergencia es uno de los métodos aprobados por la Administración de Drogas y Alimentos (FDA) para mujeres que debe estar cubierto por la mayoría de los planes de salud, incluidos los que se venden en el mercado de seguros. Sin embargo, debe ser recetada por un profesional de salud para que la mayoría de los planes la cubran. Si no tiene una receta, probablemente tendrá que pagar el costo total de su…

  • 2026 Medical Loss Ratio Rebates

    Issue Brief

    Insurers estimate they will pay $759.2 million in Medical Loss Ratio (MLR) rebates in 2026 to select individuals and employers that purchase their health coverage, according to a KFF analysis of preliminary data reported to state regulators. The estimated rebate for 2024 is less than rebates issued in most prior years.

  • 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.

  • Doing More and Defying Labels in New Mexico

    From Drew Altman

    In a new column, Dr. Drew Altman, KFF's Founding President and CEO, discusses how New Mexico made childcare universal and became the only state to fully replace lost enhanced ACA tax credits while its leaders avoided polarizing labels like “progressive or “socialist.”