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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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  • What is a grandfathered plan? How do I know if I have one?

    FAQs

    Grandfathered plans are those that were in existence on March 23, 2010, and have stayed basically the same. Grandfathered plans are not required to provide all of the benefits and consumer protections required by the Affordable Care Act. For example, a grandfathered plan might not cover preventive health services, it might charge higher premiums based on health status or gender, and it might exclude coverage for pre-existing conditions. If you buy coverage on your own and you…

  • Health Policy is Partisan, But It’s Also Personal

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman explores how America's big health care programs — Medicaid, Medicare, and the Affordable Care Act (ACA) — provide popular benefits valued by Americans from across the political spectrum. As partisan debates move closer to legislation, people may focus more on their personal financial concerns.

  • Quick Takes: Timely insights and analysis from KFF staff

    What did Sen. JD Vance mean by ‘Reinsurance?’

    Quick Insights

    Vance’s debate comment likely refers to state reinsurance waivers, largely approved by the Trump Administration. These waivers aimed to lower unsubsidized premiums by offsetting insurer costs for very sick enrollees.

  • Again, No Medicaid

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman explains why Medicaid, despite former President Donald Trump's silence on the topic, warrants greater attention given the potential for drastic changes or cuts to it should Republicans win control in the election.

  • Medical Debt: The Canary in the Coal Mine for Health Care Affordability

    Perspective

    With Vice President Harris promising to address medical debt as part of her economic plan, KFF Executive Vice President for Health Policy Larry Levitt explores why it is a symptom of the broader problem of affordable health care and reviews recent efforts to address it in this JAMA Health Forum post.