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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.

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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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  • Medicaid and Community Health Centers: The Relationship Between Coverage for Adults and Primary Care Capacity in Medically Underserved Communities

    Issue Brief

    Community health centers play an important role in providing care to uninsured and low-income individuals living in medically underserved communities. They rely on many different revenue sources and, over time, Medicaid has become a central source of funding for most health centers. To better understand how Medicaid influences health center practice, this paper compares the strength of health centers in states that have expanded Medicaid coverage for adults to health centers states with more limited…

  • Pulling It Together: The Falloff in Utilization: “There’s Something Happening, Here, What It Is Ain’t Exactly Clear”

    Perspective

    For as long as I have been in the field, we have seen cycles in health care costs. Per capita health spending would rise, then moderate, then rise gain. My colleague Larry Levitt and I documented this in The Sad History of Health Care Costs and my friend Dr. Jim Mongan called it “the peaks and valleys” of health care costs. We have never been sure whether the "valleys" were the result of government actions, such…

  • The Uninsured And The Difference Health Insurance Makes

    Fact Sheet

    This fact sheet describes the characteristics of the uninsured and explains the recent increase in this population. It also examines the difference that health insurance can make and how health reform is expected to cover millions more people.

  • Kaiser Health Tracking Poll: Election 2008 — March 2008

    Poll Finding

    Growing economic worries have led to a sharp rise in the economy as a campaign issue, eclipsing health on voters’ priority list, as well as Iraq. With economic concerns rising, where will health fit in the ongoing presidential campaign?  This March 2008 poll finds that health care plays a role in two ways: as an independent issue, and as part of the voters’ growing concerns about the economy. Health care ranks third as the issue…

  • Pulling It Together: The “R” Word Is Back

    Perspective

    Longer ago than I care to admit, I got my start in health policy at M.I.T. when I wrote a book about health care regulation. The book was about a long forgotten attempt to rationalize the health care system through an elaborate health planning program set up in the seventies under the National Health Planning and Resources Development Act. It established a system of federal, state and regional planning bodies to control health care costs by limiting the supply of…

  • Explaining Health Care Reform: Questions About Health Insurance Exchanges

    Issue Brief

    The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, made broad changes to the way health insurance will be provided and paid for in the United States. PPACA created a new mechanism for purchasing coverage called Exchanges, which are entities that will be set up in states to create a more organized and competitive market for health insurance by offering a choice of health plans, establishing common rules regarding the…

  • Pulling it Together: Implementation

    Perspective

    When I was a graduate student at MIT my adviser Jeffrey Pressman was a great political scientist who had just written the seminal book on program implementation.  It was called, simply enough, Implementation, with a subhead that read: "how great expectations in Washington are dashed" (OK, we political scientists study politics too much and are a little cynical at times).  The book literally created a new subfield in political science focusing on program implementation.  This…

  • Explaining Health Care Reform: Key Changes to the Medicare Part D Drug Benefit Coverage Gap

    Issue Brief

    On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. The health reform law, as modified by the Health Care and Education Reconciliation Act of 2010 which passed the House of Representatives on March 21, 2010 and is under consideration in the Senate, makes several key changes to the Medicare Part D drug benefit to reduce Part D enrollees’ out-of-pocket liability when they reach the coverage gap, known as…

  • Opportunities and Resources to Expand Enrollment During the Pandemic and Beyond

    Issue Brief

    This analysis summarizes recent interviews with marketplace navigators and other consumer assistance professionals, who offered observations about the 2021 Open Enrollment period, discussed general and pandemic-specific challenges facing consumers seeking coverage, and offered suggestions to improve enrollment outcomes. The brief also reviews information about federal marketplace resources and spending priorities contained in Trump Administration budget documents, and possible sources of funding for a COVID-19 special enrollment period during the Biden administration.