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Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age. Our analysis shows that older enrollees with moderate to higher incomes have been hit hardest.
This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.
This brief explains the limitations of early data in understanding the impact of the expiration of enhanced premiums tax credit on ACA enrollment. It also provides a timeline of when more complete data will become available.
The Health Spending Explorer on the Peterson-KFF Health System Tracker helps users examine five decades worth of numbers documenting expenditures by federal and local governments, private insurers, and individuals on 15 categories of health services, including hospitals, physician and clinic care, and prescription drugs.
After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating State-Based Marketplaces (SBMs), have been preparing for this possibility for months and are moving to blunt the impact on consumers by implementing their own state-funded subsidies and implementing other programs aimed at stabilizing the cost of unsubsidized premiums.
Enhanced premium tax credits expire at the end of this year. Among those with incomes over 400% poverty who are losing the tax credit altogether, the impact will be greatest for those whose unsubsidized premiums are highest: older Marketplace enrollees and those living in higher-premium locales. The maps in this brief show how much average premium payments would increase for 2026 benchmark silver plans with the expiration of enhanced premium tax credits at three income…
This analysis documents average deductibles for Affordable Care Act Marketplace plans available on Healthcare.gov in 2026 for all metal tiers, including silver plans after cost-sharing reductions are applied, as well as trend data since 2014.
The ACA's enhanced premium tax credits expired at the end of 2025. This calculator estimates how much out-of-pocket premium payments would increase for families without the enhanced credits. The projected premium increases are estimated based on family income, zip code, size, ages, and 2026 ACA Marketplace premiums.
With the onset of the COVID-19 pandemic, deaths due to drug overdose among adolescents more than doubled, primarily driven by the synthetic opioid, fentanyl. National survey data show that while the percent of adolescents (ages 12-17) with a past year substance use disorder decreased from 2021 to 2024, the share of adolescents with a past year opioid use disorder remained stable over the same period. Additionally, less than one-third of adolescents with a past year opioid use…
The ACA Marketplace Open Enrollment season begins November 1, and with it comes looming changes to the enhanced premium tax credits, increases in out-of-pocket premium payments, new Marketplace eligibility rules, and more. Read our analysis of what these and other changes could mean for new and returning enrollees.
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