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Affordable Care Act

The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

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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  • 2008 Update on Consumers’ Views of Patient Safety and Quality Information

    Poll Finding

    2008 Update on Consumers' Views of Patient Safety and Quality Information An updated examination of consumers' views on health care quality information reveals major challenges remain in providing the public with comparative quality information and encouraging its use. The 2008 Update on Consumers' Views of Patient Safety and Quality Information finds that three in 10 (30%) Americans say they have seen health care quality comparisons of health insurance plans, hospitals, or doctors in the past…

  • Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

    Issue Brief

    To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which can vary in terms of the level of coverage required for compliance, the cost of the penalty to employers who do not offer, and whether…

  • The Digital Divide And Access To Health Information Online

    Poll Finding

    The Affordable Care Act (ACA) calls for a number of web-based initiatives, including development of the website healthcare.gov which provides a variety of health information and helps individuals find coverage options. Therefore, understanding the level and quality of Internet access among those groups most likely to benefit from reform, such as the uninsured, those with lower incomes, and members of racial and ethnic minority groups, is an important consideration as health reform is implemented. A…

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for their proposed high premium increases. The analysis shows that people buying health insurance on their own in the individual market…

  • Rate Review: Spotlight on State Efforts to Make Health Insurance More Affordable

    Other Post

    The Patient Protection and Affordable Care Act creates a new federal role to examine “unreasonable increases” in the premiums charged for certain individual and small group health plans. Under the health reform law, the U.S. Department of Health and Human Services (HHS) will work with state insurance departments to conduct an annual review of unreasonable rate increases, and insurers must provide justification for such increases to HHS and to the public via their websites. The…

  • Health Insurance Market Reforms: Rate Restrictions

    Fact Sheet

    Rate restrictions limit how much insurance companies can vary premiums charged to individuals and businesses based on factors such as health status, age, tobacco use and gender. Currently, federal law does not place any limits on the ways that insurance companies set their premium rates. However, beginning January 1, 2014, insurance companies must meet the Affordable Care Act's minimum premium rating rules for health plans for individuals and small businesses. This brief explains the current…

  • Health Care After the Supreme Court Decision: What’s Next?

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation discuss the recent Supreme Court ruling on the constitutionality of the health reform law. Panelists explore such questions as: What does the court's ruling mean for those without health insurance? Will states that choose to participate in the Medicaid expansion be ready to cover nearly all non-disabled adults under age 65 with household incomes at or below 133 percent of the federal poverty level as…

  • Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information

    Report

    Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information This report reviews Medicare's payment policies as they may affect medical care for residents in long-term care environments, including a look at the financial incentives that could play a role in hospital and skilled nursing facility admissions. The report was prepared by Henry Desmarais at Health Policy Alternatives for the Foundation and released at an Oct. 12, 2010, policy briefing. Report (.pdf)

  • The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers

    Fact Sheet

    For many years, Section 1115 waivers have been used in the Medicaid program to provide states an avenue to test and implement coverage approaches that do not meet federal program rules, but there have been longstanding concerns about the lack of public input and transparency in the waiver approval process. As a result, the Affordable Care Act required the Department of Health and Human Services to issue regulations designed to ensure that the public has…

  • Kaiser Health Tracking Poll: Election 2008 – June 2008

    Poll Finding

    The latest Kaiser Health Tracking Poll: Election 2008 poll finds that the recent economic downturn continues to create serious financial problems for most Americans. When asked about the impact of recent economic changes, nearly six in 10 adults (59 percent) report having a "serious problem" with one of seven major financial issues, including one in four who cite paying for health care as a serious problem. Not surprisingly, with gas prices topping $4 per gallon…