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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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  • State Marketplace Profiles: Massachusetts

    Other Post

    Final update made on September 29, 2013 (no further updates will be made) Establishing the Marketplace On April 12, 2006, former Governor Mitt Romney (R) signed into law comprehensive health reform legislation designed to provide near-universal health coverage for state residents.1  The Massachusetts health reform law became the model for national health reform. An important component of the law was the creation of the Massachusetts Health Connector, a health insurance marketplace that manages several coverage programs.…

  • Coverage of Contraceptive Services: A Review of Health Insurance Plans in Five States

    Report

    The Patient Protection and Affordable Care Act (ACA) requires most private plans to provide coverage for women’s preventive health care, including all prescribed FDA-approved contraceptive services, without cost sharing. To better understand how this provision is being implemented by health plans, Kaiser Family Foundation (KFF) staff, with the Lewin Group, reviewed the insurance plan coverage policies for 12 prescribed contraceptive methods (excluding oral contraceptives). This report presents information from 20 different insurance carriers in five…

  • Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces

    Issue Brief

    This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities in 10 states plus DC. Premium changes for the benchmark silver plans vary significantly across the sample cities. The benchmark rates will increase 4.4 percent on average in 2016 without accounting for tax credits, a relatively modest amount but greater than the average increase for 2015.

  • 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,…

  • Community Health Centers in an Era of Health System Reform and Economic Downturn: Prospects and Challenges

    Issue Brief

    This issue brief reviews the role of community health centers in the nation's health care safety net. The centers provided comprehensive primary care to 16.1 million patients in 2007, many of them from lower-income families and medically underserved communities. The role of the centers is even more critical during an economic recession when families are more vulnerable to economic loss and unmet health needs. Issue Brief (.pdf)

  • Medicaid and CHIP Health Reform Implementation Timeline

    Issue Brief

    This timeline highlights the implementation dates for provisions in the new health reform law that are related to Medicaid and the Children's Health Insurance Program. While major expansions of Medicaid are set to occur in 2014, many other key provisions in the health reform law become effective between 2010 and 2014. Timeline (.pdf)

  • Optimizing Medicaid Enrollment: Spotlight on Technology – Wisconsin’s ACCESS Internet Portal

    Issue Brief

    This brief examines how ACCESS, a web-based, self-service tool developed by the state of Wisconsin, helps Wisconsin residents find out whether they may be eligible for BadgerCare Plus and other public programs, as well as apply for benefits, check and renew benefits, and report changes to keep their eligibility current -- all online. It is the second brief in a Spotlight on Technology series profiling several states' innovative applications of technology to Medicaid enrollment efforts.…