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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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  • New Reports Find States Expecting 7.4 Percent Growth in Medicaid Spending In Fiscal Year 2011 As the Recession’s Lingering Effects Drive Up Enrollment

    News Release

    States Face New Budget and Workforce Challenges As Temporary Federal Aid Nears End And Health Reform Planning Heats Up WASHINGTON, D.C. – Due to the nation’s deep recession, states experienced rapid growth in their Medicaid enrollment and spending last year and expect additional growth, though at a slower pace, in fiscal year 2011, according to a survey of state Medicaid officials in all 50 states released today by the Kaiser Family Foundation’s Commission on Medicaid and…

  • Kaiser Family Foundation Launches Online Health Reform Source to Explain, Analyze, and Track the New Law’s Implementation

    News Release

    New Initial Features Include Animated Movie Explaining the Law, Policy and Public Opinion Monitoring, and State-Specific Data MENLO PARK, Calif. -- Nearly six months since the signing of the Patient Protection and Affordable Care Act and as some key provisions are due to be implemented, the Kaiser Family Foundation today launched an online gateway providing easy access to new and comprehensive resources on the health reform law.  Recognizing the transition from the debate about passage…

  • Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act

    Issue Brief

    The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research, this brief identifies five key lessons learned through previous Medicaid and CHIP experience to help inform outreach and enrollment under the ACA. The brief is…

  • How the Midterms Factor Into Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how Democratic victories in several close gubernatorial races on Tuesday could revive efforts to expand Medicaid.

  • Web Briefing for Journalists: Consumer Issues Ahead of the Affordable Care Act’s Second Open Enrollment Season

    Event Date:
    Event

    The Affordable Care Act's second annual open enrollment period starts Nov. 15 and runs until Feb. 15 -- a three-month window for Americans to shop for and purchase new health coverage, or change their plan through Healthcare.gov or their state-run insurance marketplace.  This year's open enrollment season poses both new and recurring challenges for consumers:  How are premiums for marketplace plans changing, and what do the changes mean for consumers?  Why might current marketplace customers…

  • Media Availability on the U.S. Supreme Court’s King v. Burwell Decision

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call with key experts on the Affordable Care Act (ACA), state marketplaces and more to explain the U.S. Supreme Court's decision in the King v. Burwell case and to answer questions about its implications. The petitioners in the case are challenging the legality of premium and cost-sharing subsidies for low- and middle-income people buying health plans in 34 states where the federal government rather than the state…

  • After King v. Burwell Ruling, Health Law Issues Involve Implementation

    News Release

    After today’s Supreme Court ruling upholding the Affordable Care Act’s federal subsidies, Drew Altman's latest column in The Wall Street Journal's Think Tank explores what the decision means and what’s next for the health law. All previous columns by Drew Altman are available.