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Affordable Care Act

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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

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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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  • Explaining Health Reform: Medicare and the New Independent Payment Advisory Board

    Issue Brief

    This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while maintaining quality and access to care for beneficiaries. The board’s recommendations automatically take effect the next year unless Congress adopts an alternative plan to achieve…

  • Pulling it Together: The “Third School” for Controlling Health Care Costs?

    Perspective

    For as long as I have been in the field, there have been two dominant schools of thought about how to control health care costs. One school, The Regulators, believed that the best way to slow increasing costs was to control the total resources going into the health care system: putting limits on the supply of medical professionals, technology and facilities; setting payment rates; or putting enough purchasing power in the hands of government to…

  • Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

    Issue Brief

    This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…

  • West vs. South: Regional Differences in Views of the Health Reform Law

    Poll Finding

    This Data Note examines regional variations in public opinion of the health reform law based on the November 2010 Kaiser Health Tracking Poll. The analysis takes a special look at the Western and Southern regions of the country, where many states are likely to see the biggest increases in coverage under the law, and which stand to be disproportionately eligible for federal Medicaid funds. Despite these similarities in how the two regions might be affected,…

  • Articles Examine Data and Issues For Expanding Integrated Care Models For Dual-Eligible Beneficiaries

    Report

    As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care arrangements, and raise issues to consider for proposed reforms aimed at better coordinating their care and reducing health care spending. The first highlights the diversity…

  • Vermont Health Care Reform Plan

    Fact Sheet

    On May 25, 2006, Vermont Governor Jim Douglas signed into law comprehensive health care reform legislation. The plan is designed to increase access to affordable health care while reducing cost through quality improvement measures. The plan requires employers to provide or help finance coverage for their workers. For individuals, participation in the new coverage program is voluntary, though the state legislature will reevaluate the need for an individual mandate if 96 percent of state residents…

  • Presidential Candidates’ Platforms Reflect Sharp Differences in Perspectives of Democratic and Republican Primary Voters on Health Care Problems

    Poll Finding

    Embargoed for release until:Wednesday, January 23, 2008 For further information contact: Kate Schoen, Kaiser, (650) 854-9400, kschoen@kff.orgTodd Datz, HSPH, (617) 432-3952, tdatz@hsph.harvard.edu Presidential Candidates’ Platforms Reflect Sharp Differences in Perspectives of Democratic and Republican Primary Voters on Health Care Problems Analysis Draws On Data From New Kaiser/Harvard Survey of Likely Voters in Early Primary States, As Well As 10 Recent National Polls With the next wave of presidential primary elections quickly approaching, researchers from Harvard…

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Kaiser Health Tracking Poll — August 2009

    Poll Finding

    The August Kaiser Health Tracking Poll finds a slim majority of Americans continues to favor moving forward on health care reform now despite an intensifying ad war and a political climate of contentious town hall meetings that coincide with rising concerns about the reform effort. Fifty-three percent of the public believes that tackling health reform is more important than ever, compared to 42 percent who say we cannot afford to take on health care reform…