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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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  • Medicare and Dental Coverage: A Closer Look

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. This brief provides new data on the share of Medicare beneficiaries with dental coverage, the share with a dental…

  • The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election

    Issue Brief

    As the Trump administration reaches the end of its first term, this issue brief considers the landscape of approved and pending Section 1115 Medicaid demonstration waivers under this administration and how the November 2020 presidential election may impact this landscape.

  • Summary of Costs and Impact of the Prescription Drug Provisions in the Build Back Better Act

    News Release

    As the House-passed Build Back Better Act moves to the Senate, a new explainer from KFF summarizes the key prescription drug provisions within the broader budget reconciliation bill. These provisions would lower prescription drug costs paid by people with Medicare and private insurance and curb drug spending by the federal government and private payers. The Congressional Budget Office estimates federal budget savings from the drug pricing provisions would be $297 billion over 10 years. Although…

  • Health Care Inflation in the U.S.

    Event Date:
    Event

    The pressures of inflation are far reaching, affecting providers, insurers, government programs such as Medicaid and Medicare, and, ultimately, the American people. Over the coming months, health care providers and insurers will wrap up pricing negotiations and set premiums for the next year. Amid these negotiations, there remain big questions as to how economic policy and legislation such as the Inflation Reduction Act will influence pricing and payment for insurance and health care, including prescription…

  • The Implications of the Public’s Pre-existing Condition Amnesia

    Perspective

    KFF’s Larry Levitt discusses waning awareness of the Affordable Care Act’s provisions protecting people with pre-existing conditions and examines the Republican Study Committee's budget proposal, which proposes to repeal the provisions.

  • Marketplace Enrollees with Unpredictable Incomes Could Face Bigger Penalties Under House Reconciliation Bill Provision

    Issue Brief

    This analysis illustrates how provisions included in the House budget reconciliation bill could expose Marketplace enrollees with unpredictable incomes to higher penalties when filing taxes if they underestimate their incomes. About one in four potential Marketplace shoppers had incomes that varied at least 20 percent from the beginning to the end of the year.

  • How the Trump Administration and Congress Are Reshaping the Affordable Care Act’s Marketplaces: Views from the States

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    Event

    Through regulations and the House budget reconciliation bill, significant changes are being considered by Congress and the Trump Administration for how the Affordable Care Act’s health insurance Marketplaces would work. To examine how these changes could reshape the ACA’s Marketplaces, KFF held a virtual briefing on June 11 featuring leaders from two state-based Marketplaces to get perspectives from the field.