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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  • New KFF Poll Finds that Many Older Voters Are Unaware of Medicare Drug Price Negotiation, But Awareness Has Grown

    News Release

    A new KFF poll finds that many older voters are unaware of the provision in the Inflation Reduction Act that for the first time requires the federal government to negotiate the price of some prescription drugs in the Medicare program, a key campaign issue for President Joe Biden. The 48% of voters ages 65 and older who are aware of the landmark change represents a 12 percentage point increase from November, the poll shows.  Fifty-two…

  • KFF Health Tracking Poll May 2024: Voters’ Views of Health Policy Issues in Context of Presidential Campaigns

    Feature

    Voters are split largely along partisan lines in terms of who they trust in regard to various health care issues, but Biden captures more than Trump trust from Independent voters. Biden is also more trusted by older adults when it comes to entitlement programs. Voters are still largely unaware of the drug pricing provisions of the Inflation reduction Act. Large majorities of voters, particularly Democratic voters, support a federal right to abortion.

  • SCOTUS Case Could Weaken the Impact of Regulation on Key Patient and Consumer Protections

    Issue Brief

    This brief discusses the longstanding legal doctrine, Chevron deference, being challenged in two cases before the U.S. Supreme Court and includes examples of what could be at stake for health care consumers should federal courts no longer use this doctrine to address litigation related to federal health regulations. The focus here is on patient and consumer protection regulation, but overturning the Chevron deference would have implications in all areas of health care.

  • More On Health and Politics: The Peculiar Timing of Republican Health Policy Plans

    From Drew Altman

    In this column, KFF President and CEO Drew Altman examines the conservative Republican Study Committee’s sweeping proposals to remake Medicare, Medicaid and the Affordable Care Act and their potential to make waves in this year’s elections. Whether former President Trump ignores, embraces, or repudiates their ideas will be key.

  • The Symbolic Manipulation of Health Issues in Elections

    From Drew Altman

    KFF President and CEO Drew Altman explains why data and facts, policy plans and lists of accomplishments do not connect with many voters. Understanding the symbolic dimensions of politics and issues is critical for experts. We can reach a share of the public with facts and data but need additional strategies to reach everyone, including storytelling and trusted messengers.

  • Access to Adult Dental Care Gets Renewed Focus in ACA Marketplace Proposal

    Policy Watch

    Adult dental care can lead to high out of pocket costs for consumers, especially for those with private insurance coverage. This post analyzes a proposed provision in the HHS Notice of Benefit and Payment Parameters for 2025, and possible implications for consumers who have Marketplace coverage.

  • Employer Responsibility Under the Affordable Care Act

    Other Post

    The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how…

  • Preventive Services Covered by Private Health Plans under the Affordable Care Act

    Fact Sheet

    Note:  This content was updated on February 28, 2024  to incorporate new FAQs from CMS. Tables 1 and 2 were also updated to include updated recommendations. It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any patient cost-sharing. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating…