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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

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • KFF Health Tracking Poll: Public Views on Fraud in Government Health Programs

    Poll Finding

    As the 2026 midterms approach, health care costs remain voters' top health priority, but fraud in government health programs, including Medicaid and Medicare, is resonating with Republican voters, 55% of whom say it's extremely important for candidates to address. Most voters say there is at least “some” fraud in government health programs, but larger shares say there is fraud in the tax system, defense, and foreign aid, while the smallest share sees fraud in the…

  • How Has ACA Marketplace Enrollment Changed Across States in 2026?

    Issue Brief

    Following several years of rapid enrollment growth in the Affordable Care Act (ACA) Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in ACA Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the expiring federal enhanced tax credits, generally…

  • Poll: Costs Are the Top Health Care Issue for Voters in the Midterms, But Fraud Tops Republicans’ List As Trump Administration Pushes Crackdown

    News Release

    Health care costs top the list of voters’ health care priorities for the midterm elections, though more than half of Republican voters say it is extremely important for candidates to discuss the issue of fraud in government health programs, according to a new KFF Health Tracking Poll. Most voters say there is at least “some” fraud in government health programs, but larger shares of voters see fraud in the tax system, defense, and foreign aid…

  • KFF Health Tracking Poll: Health Care Costs, Expiring ACA Tax Credits, and the 2026 Midterms

    Poll Finding

    Looking ahead to the midterm elections, health care costs are the public’s top economic concern, and many voters say the issue will have a major impact on their vote. On health care issues, including the cost of health care, voters currently trust Democrats more than Republicans, though neither party has an advantage on addressing the overall cost of living. Following the expiration of the ACA enhanced tax credits, two-thirds of the public say Congress did…

  • Health Policy in 2026

    From Drew Altman

    In a new column, President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”

  • The New Ideas Conundrum in Health Policy

    From Drew Altman

    In a new column, President and CEO Dr. Drew Altman writes about the "conundrum of health policy ideas" facing Democrats searching for new proposals because of competing, and complex, priorities: rebuilding Medicaid and the ACA after trillion-dollar cuts, reconstructing federal health agencies, and tackling underlying health care costs, when candidates want simple ideas they can campaign on and voters want their costs to come down.

  • How Unaffordable is Health Care? 

    Video

    Health care affordability is a top issue for many people. Why and how did care get so expensive? In this three-part video series, KFF experts look at the rising cost of health care in the U.S. from the macro level to the issues facing everyday Americans. Drawing on KFF policy analysis and polling, the videos examine the underlying drivers of health care spending, the true cost of employer sponsored health insurance and whether the Affordable…

  • Taking Stock and Taking Steps: A Report from the Field after the First Year of Marketplace Consumer Assistance under the ACA

    Report

    This report summarizes experiences of Marketplace assistance programs as they helped consumers enroll in coverage during the first Open Enrollment period under the Affordable Care Act. Insights about what worked and where improvements could help are drawn from discussions of assisters and other experts who participated in a Consumer Assistance Roundtable, jointly sponsored by the Kaiser Family Foundation and the Robert Wood Johnson Foundation in June, 2014.

  • The Georgia Health Care Landscape

    Fact Sheet

    The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Georgia and elsewhere across the country. Thousands of Georgians have enrolled in health coverage through the new Health Insurance Marketplace, but Georgia has not implemented the Medicaid expansion, and many low-income adults in the state will likely remain uninsured. This fact sheet provides an overview of the population health, health coverage,…