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The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • It’s Not a Health Care Election, But Health Issues Might Still Add Up

    From Drew Altman

    In this column, KFF President and CEO Drew Altman explores the potential for some health care issues—including abortion, drug costs and other affordability challenges—to influence enough voters in swing states to make a difference in this year's presidential election.

  • Health Care Costs Top the Public’s List of Financial Worries, and Those Who Are Struggling the Most Want to Hear Presidential Candidates Discuss Economic and Health Care Issues

    News Release

    At a time when kitchen table economic problems are on voters’ minds, unexpected medical bills and health care costs top the public’s list of financial concerns, and voters who are struggling to pay their monthly bills are the most eager to hear the presidential candidates talk about economic and health care issues, the latest KFF Health Tracking Poll finds. Nearly 3 in 4 adults say they are worried about being able to afford unexpected medical…

  • What Would Another Trump Presidency Mean for Health Care?

    Perspective

    In a new column in JAMA Health Forum, Larry Levitt, KFF’s executive vice president for health policy, explores what a second Trump presidency might mean for health policy based on his record and remarks, including potentially weakening the Affordable Care Act, reducing federal Medicaid costs, and restricting access to abortion.

  • 3 Charts: Medicare Drug Price Negotiations

    News Release

    Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription drugs and Part B covers physician-administered medications. This new requirement is the culmination of years of debate among lawmakers in Congress, and the Centers for…

  • Another Year of Record ACA Marketplace Signups, Driven in Part by Medicaid Unwinding and Enhanced Subsidies

    Policy Watch

    Open enrollment for the Affordable Care Act (ACA) Marketplaces is about to wrap up with another record high number of people signing up for coverage. Factors that contribute to this increase include unwinding of the Medicaid continuous enrollment, increased subsidies from the American Rescue Plan and Inflation Reduction Act, and increased marketing, outreach, and enrollment assistance.

  • Florida’s Plan to Import Prescription Drugs from Canada, the First of its Kind, May Face Obstacles that Could Delay Implementation and Savings

    News Release

    A new KFF policy watch explains some of the hurdles the state of Florida still must clear before it can implement its novel plan to make some prescription drugs more affordable by importing them from Canada. Florida’s plan represents the first time the Food and Drug Administration (FDA) has granted authority for a state to safely import prescription drugs from another country. However, the state must take some additional steps to move forward with the…

  • What to Know About the FDA’s Recent Decision to Allow Florida to Import Prescription Drugs from Canada

    Policy Watch

    Florida’s plan to import certain prescription drugs from Canada represents the first time the Food and Drug Administration (FDA) has granted authority for a state to safely import prescription drugs from another country. This policy watch analysis unpacks some frequently asked questions related to state of Florida’s importation plan, including potential obstacles to implementation, who will benefit from any savings, and what types of drugs will (and will not) qualify for importation.

  • Record ACA Marketplace Signups for 2024 Are Driven in Part by Medicaid Unwinding and More Affordable Coverage 

    News Release

    Enrollment in the Affordable Care Act (ACA) Marketplaces will hit another record high in 2024, with sign-ups to date topping 20 million—already 4 million above last year’s record high. The Medicaid unwinding, enhanced Marketplace subsidies that make coverage more affordable, as well as increased marketing, outreach, and enrollment assistance have all played a role in this growth, according to a new analysis from KFF. Marketplace sign-ups have nearly doubled since 2020. The Medicaid unwinding is…

  • The CBO Report That Didn’t Roar

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman discusses a recent Congressional Budget Office (CBO) estimate that the Centers for Medicare and Medicaid Innovation (CMMI)'s payment and delivery demonstrations have cost Medicare money, and what it means for the future of value-based payment.