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The ACA MarketplaceS

Tracking Insurer Changes in the ACA Marketplaces in 2027

As of June 22, six carriers have announced that they will exit the Marketplaces in plan year 2027, either in some or all states that they are currently offering plans; four carriers have announced they will enter new Marketplaces.

An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even triple digits – with the expiration of enhanced tax credits.

POLLING on the ACA

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Section 1332 State Innovation Waivers: Current Status and Potential Changes

    Issue Brief

    Section 1332 of the Affordable Care Act (ACA) authorizes states to waive key requirements under the law in order to experiment with different health coverage models. As Republicans in Congress debate repeal and replacement of the ACA, renewed attention is being paid to these waivers as a mechanism for giving states flexibility to restructure their health care markets. This brief describes current 1332 waiver activity, including proposals in the Senate's Better Care Reconciliation Act (BCRA),…

  • Public Wants Republicans to Work with Democrats on Health Care

    From Drew Altman

    In this column for Axios, Drew Altman discusses a new poll finding showing substantial support for Republicans to drop repeal and work with Democrats on improving the Affordable Care Act, from the general public, Trump supporters, and Republicans.

  • Five Ways the Graham-Cassidy Proposal Would Affect Women

    Fact Sheet

    The Graham-Cassidy Senate proposal to repeal and replace the Affordable Care Act that could have a far-reaching impact on women's health care access and coverage. A new fact sheet outlines the ways women could be affected.

  • How Medicaid Section 1115 Waivers Are Evolving: Early Insights About What to Watch

    Issue Brief

    While efforts to pass major federal legislation to repeal and replace the Affordable Care Act (ACA) and restructure and reduce federal Medicaid financing may be on hold temporarily, the focus of the Centers for Medicare and Medicaid Services (CMS) and states is expected to turn to achieving significant Medicaid program changes through Section 1115 demonstration waivers. This issue brief presents three questions to help analyze the evolution of federal waiver policy as new waiver proposals…

  • U.S. Public Opinion on Health Care Reform, 2017

    Feature

    This slideshow supports a Visualizing Health Policy infographic with JAMA, spotlighting public opinion on health reform in the United States as of 2017, including priorities and views of the Affordable Care Act (also known as Obamacare) and its provisions.

  • Early Implementation Experience of Medicaid Expansion Waivers in Michigan and Indiana Can Help Inform Future Medicaid Waivers

    News Release

    Michigan and Indiana, led by Republican governors, each obtained a waiver from the Obama Administration to expand Medicaid in ways that differ from the terms of the Affordable Care Act. Notably, both states’ expansions include provisions related to charging enrollees premiums, requiring them to contribute to health accounts and providing incentives to participate in healthy behavior programs, though the details and implementation vary considerably between the two states. A new analysis from the Kaiser Family…

  • Three Quarters of the Public, Including a Majority of Trump Supporters, Want President Trump to Try to Make the Affordable Care Act Work

    News Release

    Americans See Many Factors Behind AHCA’s Failure, But Few Republicans Blame President Trump Despite divided views about the Affordable Care Act, three-fourths of the public (75%) say President Trump and his administration should do what they can to make the law work, while one in five (19%), including 38 percent of Republicans, say the Administration should do what it can to make the law fail so they can replace it later, the latest Kaiser Health…

  • A Warning From the Polls About Letting Obamacare “Explode”

    From Drew Altman

    In this column for Axios, Drew Altman sees a warning for the Trump administration and Republicans in the latest Kaiser Tracking Poll: the more they do to undermine the Affordable Care Act marketplaces the more the public is likely to hold them, and not the Democrats, accountable for the problems with the law.

  • JAMA Forum: Is the Affordable Care Act Imploding?

    Perspective

    In this April 2017 post, Larry Levitt discusses the current status of the Affordable Care Act's health insurance marketplaces, and explains how the Trump administration's choices -- including whether to continue cost-sharing reduction payments to insurers -- could influence stability of the marketplaces going forward. The post is now available at The JAMA Forum.