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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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  • Compare Proposals to Replace The Affordable Care Act

    Interactive

    President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other? Includes the Graham-Cassidy-Heller-Johnson amendment (introduced 9/13/2017) as well as other proposals from key members of Congress.

  • How Single Payer Helps Republicans Change the Subject

    From Drew Altman

    In this Axios column, Drew Altman analyzes the political pros and cons of single payer for Democrats and whether it will shift the focus from the Republicans' failed effort to repeal and replace  the Affordable Care Act to the Democrats new sweeping plan.

  • Medicaid: What We Learned From the Recent Debate and What to Watch for in September 2017

    Issue Brief

    The inclusion of major Medicaid changes in both the American Health Care Act (AHCA) that passed in the House and the Better Care Reconciliation Act (BCRA) considered in the Senate revealed that is hard to gain consensus on significant cuts and reforms to Medicaid. Medicaid has broad general support and intense support from special populations served by the program. In addition, proposed changes would have different implications across states due to significant program variation across…

  • How to Keep ACA Stabilization Narrow

    From Drew Altman

    In this column for Axios, Drew Altman discusses the main challenges for members and media coverage as members take up the issue of stabilization of the Affordable Care Act.

  • Data Note: Strongly Held Views on the ACA

    Feature

    Since the passage of the Affordable Care Act in 2010, Kaiser Family Foundation polling has found the public divided in their overall views of the law. At the same time, an intensity gap in opinion has existed since 2010, with the share of the public holding strongly unfavorable views of the law outnumbering the share with strongly favorable views. A new analysis of Kaiser Family Foundation polling data finds that intensity gap began to close…

  • Analysis: Strong Favorable Views of ACA Increased in Spring 2017, Strong Unfavorable Views Remain Flat

    News Release

    Since the passage of the Affordable Care Act in 2010, Kaiser Family Foundation polling has found the public divided in their overall views of the law and in the intensity of their opinions: For seven years, the share of the public holding strongly unfavorable views of the law has outnumbered the share with strongly favorable views. A new analysis of Kaiser Family Foundation polling data finds that intensity gap started to close in spring 2017, as…

  • Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

    Issue Brief

    While the future of legislation to repeal and replace the Affordable Care Act (ACA) and make fundamental changes to the structure and funding of the Medicaid program is uncertain, states and the Administration may achieve major changes to Medicaid through the use of Section 1115 Medicaid waivers. Wisconsin submitted a waiver amendment request to CMS in June 2017 and Maine submitted a waiver application to CMS in August 2017. Unlike previous waivers that encompass the…

  • Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

    Feature

    Following the U.S. Senate’s failed vote on the “skinny repeal”, the latest Kaiser Health Tracking Poll finds that the majority of the public say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. A large share of Americans think President Trump and his administration should do what they can to make the current health care law work and a majority of the public…