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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.

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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  • Status of State Medicaid Expansion Decisions

    Interactive

    This page displays an interactive map of the current status of state decisions on the Affordable Care Act's Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.

  • What Could Medicaid Work Requirements Mean for People with Disabilities Waiting for Medicare Coverage?

    Issue Brief

    This analysis finds that Medicaid through the expansion pathway covered over 1 in 4 SSDI applicants and beneficiaries waiting to become eligible for Medicare (120,300 people out of a total 415,300 in 2023). In future years, people applying for and new to SSDI may experience difficulties maintaining Medicaid prior to becoming eligible for Medicare because of the new work requirements.

  • Individual Market Enrollment Continues to Fall Through Mid-2026

    Issue Brief

    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.

  • How Does ACA Marketplace Enrollment in 2026 Vary Across Congressional Districts?

    Issue Brief

    KFF’s new interactive maps illustrate ACA Marketplace enrollment and changes in enrollment by congressional district and state. Marketplace enrollment declined in most congressional districts between 2025 and 2026, with two-thirds of the decline (67%) occurring in Republican-held congressional districts.

  • Which States Will Be Affected by Key Medicaid Provisions in the 2025 Reconciliation Law?

    Policy Watch

    The 2025 reconciliation law makes sweeping changes to Medicaid that will affect every state through key eligibility and financing changes, including new work requirements, immigrant eligibility restrictions, and changes to provider taxes and state directed payments. This issue brief explains which states will be affected by each of these key provisions.

  • A Guide to the Role of Health in the Midterms

    From Drew Altman

    In a new column, President and CEO Dr. Drew Altman says health care costs are playing a significant role in the midterms as one dimension of voters’ concerns about cost of living, and explains why pollsters, analysts, and candidates should look at it that way, and not as a separate voting issue. He writes, “The ‘issue’ that matters most in this election is cost of living and the cost of health care is a central…

  • Midterm Election Update: The Affordable Care Act Marketplaces

    Fact Sheet

    More people than ever got coverage through the Affordable Care Act (ACA) Marketplaces in 2025, but the expiration of enhanced premium tax credits has driven up what people pay and contributed to declining enrollment in 2026. Law and regulatory changes also tightened ACA eligibility and enrollment requirements. Public opinion of the ACA remains generally favorable, although views remain divided along partisan lines.

  • 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.