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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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  • ¿Cuánto puedo ganar y calificar para subsidios para las primas en el mercado?

    FAQs

    Los subsidios para las primas están disponibles para quienes contratan una cobertura del mercado de seguros y cuyos ingresos son al menos iguales al nivel federal de pobreza. -Para una persona, esto significa un ingreso de al menos $15.960 en 2027. -Para una familia de cuatro, esto significa un ingreso de al menos $33.000 en 2027. Esta calculadora de subsidios del mercado de seguros puede mostrarle su elegibilidad para diferentes montos de ingresos y tamaños…

  • ¿Puedo comprar un seguro de salud por fuera del mercado que cumpla con todos los estándares de ACA?

    FAQs

    Si. Muchas aseguradoras que ofrecen planes a través del mercado también ofrecen planes idénticos por fuera. Sin embargo, por fuera del mercado no hay subsidios disponibles para ayudar a pagar las primas mensuales ni para solventar los costos compartidos. Algunas personas prefieren comprar cobertura por fuera del mercado cuando están seguras de que no califican para subsidios. Estos planes también cumplirán con todos los estándares de ACA. Cubrirán beneficios esenciales de salud; y no lo…

  • ¿Qué pasa si quiero dejar mi plan de salud del mercado durante el año?

    FAQs

    Es importante que se comunique con su mercado y con el plan de salud y les informe que ya no necesita cobertura. El enlace que se proporciona aquí ofrece detalles sobre cómo cancelar la cobertura del mercado en los estados que utilizan CuidadoDeSalud.gov. Los mercados de seguros estatales pueden tener su propio proceso para cancelar la cobertura. Si reside en uno de estos mercados, haga clic aquí para acceder al enlace que lo llevará al…

  • Democrats Hold a Nearly 2-to-1 Advantage Over Republicans on Handling the Cost of Health Care

    Poll: Cost of Health Care and Gas Top Voters’ Midterm Concerns; Democrats Hold Significant Advantage on Health Care Costs and Cost of Living 

    News Release

    Just a month away from the midterm elections, affordability worries continue to top the public’s list of midterm election issues, with health care costs and gas costs tying as the top economic concern, KFF’s new Health Tracking Poll finds. Voters overall trust Democrats more than Republicans to handle the cost of health care and the cost of living.

  • Democrats Hold a Nearly 2-to-1 Advantage Over Republicans on Handling the Cost of Health Care

    KFF Health Tracking Poll: Health Care Issues in the Lead-Up to the 2026 Midterm Election 

    Poll Finding

    With the 2026 midterms about a month away, health care costs remain tied with gas as voters’ top midterm concerns and the Democrats hold a clear edge over the Republicans Party on who voters trust to handle many top electoral issues, including the cost of health care and the cost of living. Two-thirds of U.S. adults now favor Medicare-for-all, a new high in KFF Polling, but support shifts when competing claims from critics and proponents…

  • People with HIV Who Gained Health Coverage Under ACA Are More Comfortable Navigating Insurance Two Years Later, But Problems Persist, Others Remain Uninsured

    News Release

    A new Kaiser Family Foundation report based on focus groups conducted in five states finds people living with HIV are more comfortable with navigating health insurance two years into the Affordable Care Act’s (ACA) major coverage expansions. Those in the marketplaces and Medicaid recognize their new benefits but often continue to worry about maintaining coverage and remain concerned about its affordability, and many in states without Medicaid expansion remain uninsured. The brief takes a second…

  • Aprenda sobre seguros médicos: los videos en español

    Video

    The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.

  • Puerto Rico: Fast Facts

    Fact Sheet

    Puerto Rico: Fast Facts provides a quick snapshot of the island's demographic, health, and economic characteristics. It also provides some information on federal Medicaid rules, infrastructure, and fiscal challenges ahead.