Affordable Care Act

The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the 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 Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in 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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  • The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006

    Other Post

    Health Affairs Article: The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006 A Foundation study featured as a web-exclusive Health Affairs article examines health coverage trends from 2000-2006 showing that over this period the dominant factor contributing to a rise in the uninsured population has been the decline in employer-sponsored insurance, even as the economy rebounded from the last recession. Access web-exclusive Health Affairs article

  • Health Reform and Communities of Color: Implications for Racial and Ethnic Health Disparities

    Issue Brief

    This issue brief examines the key provisions of the 2010 health reform law that will expand health coverage and are likely to improve access to care for people of color, as well as some of the other provisions that will likely have either a direct or indirect impact on health disparities. Issue Brief (.pdf)) Previous Version: November 2009 (.pdf)

  • Kaiser November Health Tracking Poll: Individual Elements of the ACA Popular with the Public

    Perspective

    After taking a negative turn in October, the public’s overall views on the Patient Protection and Affordable Care Act (ACA) returned to a more mixed status this month. Still, Americans remain somewhat more likely to have an unfavorable view of the law (44 percent) than a favorable one (37 percent). The Kaiser Family Foundation's November Health Tracking Poll also finds that individual elements of the law are viewed favorably by a majority of the public. The law’s…

  • Medicaid’s Role for Black Americans

    Fact Sheet

    This fact sheet examines Medicaid's role for black Americans. It includes data on Medicaid's coverage of black Americans and the program's impact on their access to care, as well as the impacts of the recent recession and the coming expansion of Medicaid under health reform on enrollment in Medicaid among black Americans. The fact sheet also has a chart showing state-by-state data on health insurance coverage of black Americans. Fact Sheet (.pdf)

  • Enhanced Medicaid Match Rates Expire in June 2011

    Fact Sheet

    This fact sheet discusses the role played by the enhanced federal Medicaid matching funds available to states through the American Recovery and Reinvestment Act of 2009 (ARRA), and the implications for state Medicaid programs as that extra assistance expires June 30, 2011. States used the ARRA enhanced Medicaid funding to address Medicaid funding shortfalls during the economic downturn, and to mitigate program cuts and address budget shortfalls. As national unemployment has increased in recent years…

  • Story Ideas: Impact of the Supreme Court Decision on Health Reform

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation sponsored this reporters-only briefing to help journalists assess the Supreme Court's decision about the Patient Protection and Affordable Care Act. Full version: Video   Speakers for this session: The panel was moderated by Ed Howard of the Alliance. John R. Lumpkin, Senior Vice President and Director, Health Care Group, Robert Wood Johnson Foundation Alan Weil, National Academy for State Health Policy Michael Cannon, Cato Institute…

  • Key Facts about the Uninsured Population

    Issue Brief

    The number and share of people without insurance grew in 2024, increasing for the first time since 2019, according to KFF's analysis of data from the American Community Survey (ACS). This issue brief describes trends in health coverage in 2024, examines the characteristics of the uninsured population , and summarizes the access and financial implications of not having coverage.