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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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  • Why Drug Price Negotiation Has Staying Power

    From Drew Altman

    In this Axios column, Drew Altman looks beyond Medicare to what’s at stake for employers and workers in the debate about the government negotiating drug prices.

  • Supplemental Security Income for People with Disabilities: Implications for Medicaid

    Issue Brief

    This issue brief describes key characteristics of SSI enrollees, explains the SSI eligibility criteria and eligibility determination process, and considers the implications of changes in the SSI program for Medicaid, including the effects of the COVID-19 pandemic and resulting economic downturn as well as proposals supported by President Biden that Congress might consider.

  • Recent and Anticipated Actions to Reverse Trump Administration Section 1557 Non-Discrimination Rules

    Issue Brief

    The Biden Administration has started taking steps to reverse Trump Administration policy and regulations that significantly narrowed the implementation and administrative enforcement of Section 1557, the Affordable Care Act’s nondiscrimination provision, particularly as the regulations apply to gender identity and sexual orientation. In addition, several lawsuits challenging the regulations, which were initially issued by the Obama Administration and later substantially revised by the Trump Administration, are pending. Section 1557 prohibits discrimination based on race, color,…

  • Two-Thirds of the Public Say the U.S. Should Play a Major Role in Distributing COVID-19 Vaccines Globally, But Not Most Republicans

    News Release

    With increased attention to the global need for COVID-19 vaccines and the Biden administration’s announcement today about how it plans to distribute the first portion of the 80 million doses it will share by the end of this month, the latest KFF Health Tracking Poll finds that two-thirds of the public (66%) say that the U.S. should play at least a “major role” in distributing COVID-19 vaccines to other countries, including about a quarter (27%)…

  • Expanding Medicare to Adults at Age 60 Years—Medicare-for-More?

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt examines the implications of lowering Medicare’s age of eligibility, which is emerging as a potential pathway toward Medicare-for-all or a public option among single-payer advocates. He explores the implications for costs, industry, people and broader reform efforts.

  • The Pandemic’s Impact on Children’s Mental Health

    News Release

    The pandemic has taken a heavy toll on the nation’s mental health, and a new issue brief shows that children are also facing worsening emotional and cognitive health. The brief examines factors contributing to worsening mental health and substance use outcomes among children and adolescents during the pandemic, looking closely at those who are at higher risk for negative mental health impacts, such as LGBTQ youth and children of color. A review of recent research…