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The ACA MarketplaceS

What We Know about Trump’s $500 ACA Checks and the User Fees Funding Them

This analysis examines the $500 checks that the Trump administration is sending to some Affordable Care Act Marketplace enrollees and the user fees that are paying for them. The checks are going to about 1 million enrollees in the 30 states that rely on the federal HealthCare.gov Marketplace who are not receiving any tax credits this year.

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. The enrollment decline coincides with the expiration of the enhanced premium tax credits and other policy changes that are expected to reduce 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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  • Outreach and Enrollment Strategies for Reaching the Medicaid Eligible but Uninsured Population

    Issue Brief

    This brief identifies a range of successful strategies to reach and enroll Medicaid- and CHIP-eligible individuals as well as options to facilitate renewals. It draws on a collection of previous work examining state enrollment experiences after implementation of the ACA. In sum, it shows that states that have achieved enrollment success have embraced an array of strategies and approaches that include promoting the expansion through strong leadership and collaboration, implementing broad marketing and outreach campaigns,…

  • How has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs

    Issue Brief

    To further understand how the first full year of Medicaid expansion has affected patients who are homeless and the providers who care for them, this analysis uses data from the Uniform Data System (UDS) for health centers to examine changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects serving the homeless population.

  • The ACA Ruling Shows How the Times Have Changed on Health Care

    From Drew Altman

    In this Axios column about the Texas court decision, Drew Altman shows that many provisions of the Affordable Care Act are even more popular than protections for pre-existing conditions, the issue which put Republicans on the defensive and helped Democrats in the midterm elections.

  • Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and…

  • KFF Health Tracking Poll – January 2019: The Public On Next Steps For The ACA And Proposals To Expand Coverage

    Feature

    This month's KFF Health Tracking Poll finds that about four in ten are aware of the federal judge's ruling that the ACA is no longer valid but once made aware, most disapprove of the ruling. This poll also examines the public's favorability toward expanding the role of public health care programs, and majorities across partisan groups have a favorable opinion of programs such as Medicare buy-in and Medicaid buy-in, with a national Medicare-for-all being less…

  • Poll: Majorities Favor a Range of Options to Expand Public Coverage, Including Medicare-for-All

    News Release

    At a time when debate is beginning about a national Medicare-for-all plan and other approaches to expanding coverage through public programs, this month’s KFF Health Tracking poll examines Americans’ early opinion on a range of options under consideration. The poll finds majority support for four different approaches: 77 percent of the public, including most Republican (69%), favor allowing people between the ages of 50 to 64 to buy health insurance through Medicare; 75 percent, including…

  • Coverage at Work: The Share of Nonelderly Americans with Employer-Based Insurance Rose Modestly in Recent Years, but Has Declined Markedly Over the Long Term 

    News Release

    An improving economy and the Affordable Care Act’s individual mandate may be behind a modest increase in the share of Americans with job-based health insurance in recent years, but the long-term trend remains a downward one, according to a new KFF analysis. Data from the federal National Health Interview Survey show the share of the nonelderly population covered by workplace plans rose from 56.3 percent in 2013 to 58.4 percent in 2017. That was still…

  • Most Americans – Across Parties – Say 2018 Candidates’ Position on Pre-Existing Condition Protections Will Matter to Their Vote; Do Not Want Supreme Court to Overturn These ACA Protections

    News Release

    Half in Non-Expansion States Support Their State Expanding Medicaid; More if Tied to Work Requirements With less than four months to go until the Congressional midterm general election, a candidate’s position on continuing protections for people with pre-existing health conditions is at the forefront of the many health care issues on voters’ minds, finds the latest Kaiser Family Foundation tracking poll. Continuing pre-existing condition protections ranks first among six other candidate positions on health care…