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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  • Medicaid Spending Growth and the Great Recession, 2007-2009

    Fact Sheet

    This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending. Fact Sheet (.pdf)

  • Kaiser Health Tracking Poll — November 2009

    Poll Finding

    The November Kaiser Health Tracking Poll shows little movement in measures of public opinion about health reform from recent months. Among the new findings is a ranking of the public's top priorities from among a list of elements of the legislation. There were both similarities and differences in priorities across partisan groups: while assuring the availability of affordable plans ranked in the top three priorities for Democrats, Republicans and independents, deficit neutrality ranked in the…

  • Health Care in the 2008 Presidential Primaries

    Poll Finding

    This analysis find that the sharply contrasting health care platforms of the leading Democratic and Republican presidential candidates reflect dramatic differences in the perspectives of their primary voters. The article analyzes a newly released Kaiser/Harvard survey of likely primary voters in 35 states (and the District of Columbia) with January or February primaries or caucuses, as well as data from 10 other recent surveys by national media polling organizations. The article, "Health Care in the…

  • Pulling it Together: What Conservatives Are Winning

    Perspective

    Conservatives are out of sorts these days about the direction in which health care is headed. They think the new health reform law expands the role of government too much and spends too much at a time when they believe deficit reduction should be a higher priority. The claims about death panels and a government takeover of the health system aside, these are principled positions for conservatives to take – they are supposed to be…

  • Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

    Event Date:
    Event

    The Alliance for Health Reform and The Commonwealth Fund co-sponsored this briefing to explore the health reform proposals being considered which may impose responsibilities on both individuals and employers to have and help pay for coverage and whether they will be able to pay the amounts above the subsidies. Questions addressed include:If Congress exempts people from the coverage requirement or significantly reduces the penalties for noncompliance, will enough healthy individuals purchase new coverage to adequately…