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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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  • Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes

    Issue Brief

    Medicaid payments to hospitals, which include base and supplemental payments, play an important role in hospital finances and can affect beneficiaries’ access to care.This brief provides an overview of Medicaid payments for hospitals and explores the implications of the ACA Medicaid expansion, including changes in uncompensated care, as well as payment policy changes on hospital finances.

  • Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults

    Issue Brief

    This issue brief answers 3 key questions and provides new data about state medical frailty determinations, which are assuming greater importance as more states adopt restrictive Section 1115 waivers that exempt medically frail enrollees from policies such as work requirements and premiums. The findings are excerpted from our 50-state survey on Medicaid financial eligibility for seniors and people with disabilities.

  • JAMA Forum: What Might an ACA Replacement Plan Look Like?

    Perspective

    Larry Levitt's January 2017 post explains the logistics of a "repeal and delay" approach to the Affordable Care Act, and outlines key elements of a proposed replacement plan from Rep. Tom Price, who is President Trump's nominee for Secretary of Health and Human Services. The post is now available at The JAMA Forum.

  • The Future of Contraceptive Coverage

    Issue Brief

    This issue brief explains the Affordable Care Act's current contraceptive coverage rule, the impact it has had on women, and the state of contraceptive coverage if the rule is eliminated or modified.

  • Assessing Americans’ Familiarity With Health Insurance Terms and Concepts

    Poll Finding

    With the approaching launch of the second open enrollment period for the Affordable Care Act’s (ACA) health insurance marketplaces and at a time when open enrollment is also happening for many job-based plans, the Kaiser Family Foundation conducted a nationally representative survey of 1,292 U.S. adults to shed light on Americans’ understanding of basic health insurance terms and concepts, and to identify gaps in awareness that could lead to difficulties for some individuals as they…

  • Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

    Report

    This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation's Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and…

  • How Many Employers Could be Affected by the Cadillac Plan Tax?

    Issue Brief

    As fall approaches, we can expect to hear more about how employers are adapting their health plans for 2016 open enrollments. One topic likely to garner a good deal of attention is how the Affordable Care Act’s high cost plan tax (HCPT), sometimes called the “Cadillac plan” tax or "Cadillac tax," is affecting employer decisions about their health benefits. The tax takes effect in 2018. The potential of facing an HCPT assessment as soon as…