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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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  • Veo “planes catastróficos” que parecen incluso más económicos que otros planes del mercado. ¿Qué son? ¿Puedo comprar uno?

    FAQs

    Los planes catastróficos tienen los costos compartidos más altos y las primas más bajas. En 2026, los planes catastróficos tendrán un deducible anual de $10.600 para una persona o $21.200 para una familia. El plan no tiene que cubrir más de tres consultas de atención primaria antes de alcanzar el deducible. Los planes catastróficos solo se pueden vender a ciertas personas. Consulte estas preguntas frecuentes para obtener más información. Tenga en cuenta que si es…

  • How long after I enroll in a plan will coverage take effect?

    FAQs

    During Open Enrollment in HealthCare.gov and some other states, if you enroll in a private health insurance plan by December 15 and make your first premium payment by the due date specified by your plan, your new health coverage will start January 1. If you sign up after December 15, your coverage will begin on February 1. If you sign up for a Marketplace plan during a special enrollment period, your coverage will usually take…

  • Medicare and Dental Coverage: A Closer Look

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. This brief provides new data on the share of Medicare beneficiaries with dental coverage, the share with a dental…

  • I am in my early 60s and have signed up for a Marketplace plan so that I have health insurance coverage until I qualify for Medicare at age 65. What happens when I go on Medicare?

    FAQs

    When you turn 65, you should sign up for Medicare and notify your Marketplace plan that you now qualify for Medicare coverage. Your Marketplace coverage will not be cancelled automatically by your plan when you turn 65 and sign up for Medicare, but if you receive premium tax credits to help you pay for your Marketplace plan premium, your eligibility for these tax credits will end when your Medicare Part A coverage starts (people with…

  • My employer offers a plan with very limited benefits. It only covers preventive services and a few doctor visits each year. However, this plan option is free. My employer also offers a more comprehensiv...

    FAQs

    The limited benefit plan you described probably does not meet the standard for “minimum value.” If that were the only plan your employer offered, you could qualify for premium tax credits to help pay for a more comprehensive plan on the Marketplace coverage. The premium tax credits could help you afford coverage that would be more comprehensive. However, if your employer also offers a major medical plan option that meets the test of minimum value,…

  • I just found out that I’m pregnant, and I do not have health insurance. Can I enroll in a plan through the health insurance Marketplace?

    FAQs

    Yes. However, while you are still pregnant, you may only enroll during an Open Enrollment period, which is typically from November through mid-January. Once enrolled, your plan will be required to cover maternity services. You may also qualify for a premium tax credit and/or a cost-sharing reduction, depending on your family income and your eligibility for employer coverage. After the baby is born, you can sign up for health insurance and add the baby to your plan, no…

  • Does my student health plan have to cover birth control, and if not, what are my options?

    FAQs

    It depends on the type of coverage your college or university provides. “Fully-insured” plans are required to provide, without cost sharing, access to all FDA-approved birth control (“contraceptive”) methods, sterilization procedures, and patient education and counseling prescribed by a health care provider. If your student health plan is “self-insured,” coverage of birth control services depends on which state you live in. Check with your college or university to find out what type of student health…

  • I received a Form 1095-A from the Marketplace. What is that?

    FAQs

    Form 1095-A gives you information about the amount of advance premium tax credit (APTC) you received during the previous year. A copy of this form is also reported to the IRS. Keep this form with your other tax records. The APTC you received was based on the annual income you estimated you would earn when you signed up for Marketplace coverage. Now you must file a federal income tax return to compute your actual income for that coverage…

  • I had a Marketplace plan last year, but paid the full premium myself because I made too much to qualify for premium tax credits. When I did my taxes though, my income for the year ended up being less th...

    FAQs

    Yes. Premium tax credits can be claimed in advance (during the year) or when you file your taxes. To claim the credit, you will need to file a federal income tax return and Form 8962. Follow the instructions on Form 8962 to determine the amount of tax credit you should receive as a refund when you file your taxes.

  • What is Form 8962?

    FAQs

    If you received an advanced premium tax credit (APTC) through the Marketplace last year, you must file a Form 8962 with your federal income tax return in order to "reconcile" your estimated and actual income for the year, even if you estimated your income perfectly. You can get a blank Form 8962 from the IRS website, or, if you use tax preparation software, the form will be automatically generated for you. The instructions for Form…