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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.

About the ACA

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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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  • An Overview of Actions Taken by State Lawmakers Regarding the Medicaid Expansion

    Fact Sheet

    The ACA Medicaid expansion has garnered different responses from statelawmakers - Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.

  • Summary of the Affordable Care Act

    Fact Sheet

    This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.

  • Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse Most Often Uncovered by Non-Group Health Plans

    News Release

    Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the Affordable Care Act (ACA) essential health benefits requirement took effect, finds a new Kaiser Family Foundation analysis. Other major benefits most often left uncovered before the ACA include substance abuse disorder services (inpatient and outpatient services each not covered by 45% of 2013 non-group plans) and mental/behavioral health services (inpatient and outpatient services…

  • Survey of Non-Group Health Insurance Enrollees, Wave 3

    Poll Finding

    The survey, conducted shortly after the close of the Affordable Care Act’s third open enrollment period, is the third in a series exploring the experiences of individuals who purchase their own health insurance in the nongroup market, including coverage purchased both inside and outside the ACA’s marketplaces. It examines enrollees’ satisfaction with their health plans’ premiums, deductibles, and provider networks, their views on affordability, shopping experiences, and problems encountered with their plans.

  • Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act

    Issue Brief

    Repealing and replacing the Affordable Care Act is a top priority of the Trump Administration and the Republican leadership, which could have implications for the Medicare program. This brief provides a side-by-side comparison of the Medicare-related provisions in six bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare.

  • Senate Health Bill Proposes Big Changes to Medicaid Beyond Repealing and Replacing the ACA

    News Release

    The Better Care Reconciliation Act (BCRA) under consideration in Congress includes provisions that would fundamentally change Medicaid by phasing out extra federal funding for states’ Medicaid expansions and for the first time limiting federal spending on Medicaid through a per enrollee cap on financing or a block grant for certain adults. While those measures account for most of the bill’s $756 billion reduction in federal Medicaid spending over the next decade, there are other big…

  • 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.…

  • State Exchange Profiles: Tennessee

    Other Post

    Final update made on December 10, 2012 (no further updates will be made) Establishing the Exchange On December 10, 2012, Governor Bill Haslam (R) announced Tennessee would default to a federally-facilitated health insurance exchange.1 Prior to the announcement that the state would not operate its own exchange, the Tennessee Department of Finance and Administration established the Insurance Exchange Planning Initiative to advise the Governor and Legislature on exchange implementation. The Initiative worked closely with a…