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Affordable Care Act

The ACA MarketplaceS

How Has Marketplace Enrollment Changed Across States in 2026?

Following several years of rapid enrollment growth in the ACA Marketplaces that corresponded with temporary enhanced premium tax credits, enrollment fell for the first time in seven years in 2026, when those tax credits expired. Every state except for New Mexico saw a drop in Marketplace enrollment from 2025 to 2026. State-based Marketplaces that run their own enrollment platforms, including those that partially offset the enhanced tax credits, generally saw lower drops in enrollment.

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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  • What kinds of health insurance plans do private enrollment websites sell?

    FAQs

    Private enrollment websites that are run by insurance companies typically only show plans offered by that insurer. Websites run by insurance brokers are required to show all plans offered by multiple insurers. If you have questions or concerns about information on these sites, contact the Marketplace call center, HealthCare.gov, or your state Marketplace. Many private enrollment websites also sell short-term health plans, cancer-only policies, and other less comprehensive products. These products may appear cheaper than…

  • Acabo de conseguir un trabajo con seguro médico, pero el seguro de mis padres es mejor y más económico. ¿Puedo seguir con el seguro de mis padres?

    FAQs

    Sí, puede permanecer en el plan de sus padres hasta los 26 años si ellos tienen cobertura a través del trabajo, o hasta el final del año en el que cumpla 26 si tienen cobertura del mercado. Ser elegible para recibir beneficios de salud a través de tu trabajo no te invalida para estar cubierto como dependiente en el plan de tus padres.

  • Recent and Anticipated Actions to Reverse Trump Administration Section 1557 Non-Discrimination Rules

    Issue Brief

    The Biden Administration has started taking steps to reverse Trump Administration policy and regulations that significantly narrowed the implementation and administrative enforcement of Section 1557, the Affordable Care Act’s nondiscrimination provision, particularly as the regulations apply to gender identity and sexual orientation. In addition, several lawsuits challenging the regulations, which were initially issued by the Obama Administration and later substantially revised by the Trump Administration, are pending. Section 1557 prohibits discrimination based on race, color,…

  • New Resources & Briefing Examine Medicaid Long-Term Services and Supports

    Event Date:
    Event

    The following resources by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) examine the latest data findings regarding Medicaid’s long-term services and supports for seniors and people with disabilities. The materials were released at a public briefing in the Foundation’s Washington, D.C. offices that featured an expert panel and remarks on long-term services and supports by U.S. Secretary of Health and Human Services Kathleen Sebelius. The reports include: Medicaid Home and Community-Based…

  • Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid

    Issue Brief

    This policy brief examines the structure and experience of Community Care of North Carolina, an enhanced medical home model of care that North Carolina began implementing in 1998 as part of its Medicaid program. Evaluations of the initiative, which includes a heavy emphasis on care coordination, disease and care management and quality improvement, suggest that it has resulted in both improved care and cost savings. The program provides important lessons for broader health reform efforts…

  • A Profile of Community Health Center Patients: Implications for Policy

    Issue Brief

    Community health centers are a key source of primary care in underserved areas. Their role will grow as coverage expands under the ACA. To sharpen understanding of the health center patient population, this brief compares them to the low-income population overall, using the Health Center Patient Survey and National Health Interview Survey. The pre-ACA profile of health center patients that emerges sets the stage for measuring change and highlights important implications of states’ Medicaid expansion…

  • Health Care Access and Coverage for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community in the United States: Opportunities and Challenges in a New Era

    Perspective

    This Policy Insight looks at the challenges and questions surrounding recent policy changes that are expected to increase health insurance coverage and access to care for lesbian, gay, bisexual and transgender (LGBT) individuals and their families, including the impact of the Affordable Care Act (ACA) and the Supreme Court's DOMA decision.

  • The Ohio Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and health care delivery in Ohio under the Affordable Care Act (ACA).