Affordable Care Act

The ACA MarketplaceS

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

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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  • Coordinating Coverage and Care in Medicaid and Health Insurance Exchanges

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured convened a roundtable discussion on August 31, 2010 with a group of national and state experts to discuss key issues related to coordinating coverage and care in Medicaid and the new Health Insurance Exchanges under health reform. The Patient Protection and Affordable Care Act requires states to create a coordinated, simple and technologically-supported process through which individuals may obtain Medicaid, Children’s Health Insurance Program and subsidized Exchange…

  • How Will the Uninsured in Alabama Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Alabama, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Alabama are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in New Hampshire Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in New Hampshire, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in New Hampshire are eligible for Medicaid or financial…

  • How Will the Uninsured in North Dakota Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in North Dakota, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in North Dakota are eligible for Medicaid or financial…

  • How Will the Uninsured in Washington Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Washington, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Washington are eligible for Medicaid or financial assistance in…

  • Medicare Advantage: Take Another Look

    Perspective

    This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).

  • Obamacare y Usted: Si compra seguro médico en el mercado individual

    Fact Sheet

    Si usted compra su plan de salud por su cuenta (en vez de tener cobertura a través de su empleador), usted tendrá nuevas opciones para tener su cobertura, pero la Ley del Cuidado de Salud a Bajo Precio requiere que usted esté asegurado o será multado. Qué está cubierto Bajo Obamacare, los planes de salud deben cubrir visitas al doctor, hospitalizaciones, recetas de drogas y cuidado materno sin restricciones por condiciones preexistentes, o condiciones físicas…

  • Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

    Issue Brief

    This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

  • Health Coverage and Care in the South: A Chartbook

    Report

    The South has faced longstanding disparities in health and health care, although significant variation exists between southern states. As a group, compared to those in other regions, Southerners are more likely to be uninsured, less likely to have access to needed health services, and more likely to experience a number of chronic health conditions. This chartbook provides key data on the demographic and economic characteristics of the southern population as well as their health status,…