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  • Early Indications of the Impact of the Enhanced Premium Tax Credit Expiration on 2026 Marketplace Premiums

    Issue Brief

    Every summer, health insurers submit rate filings to state regulators detailing expectations and justifying premium rate changes for ACA-regulated health plans for the coming year. With the enhanced premium tax credits set to expire at the end of 2025, consumers can expect increases in how much they pay for coverage. KFF examines 23 early insurer premium filings from Vermont, Oregon, Washington, and Washington, DC, which include an additional 4 percent increase in premiums, on average,…

  • 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.

  • ACA Marketplace Enrollment Has More Than Doubled Since 2020, with the Fastest Growth Occurring in States Won by President Trump in 2024

    News Release

    Enrollment in Affordable Care Act (ACA) Marketplace health plans reached a record 24.3 million people, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election, a new KFF analysis finds.  Almost all states have seen increases in enrollment since 2020, including six states where enrollment has more than tripled: Texas (up 255%), Mississippi (up 242%), West Virginia (up 234%), Louisiana (up 234%),…

  • Enrollment Growth in the ACA Marketplaces

    Policy Watch

    This analysis of enrollment in Affordable Care Act (ACA) Marketplace health plans finds a record 24.3 million people enrolled in 2025, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election. In six states, enrollment more than tripled from 2020 to 2025: Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee.

  • Examining School Shootings at the National and State Level and Mental Health Implications

    Issue Brief

    According to the Washington Post, at least 390,000 students were exposed to a school shooting (exposure is defined as students attending a school at which a shooting occurred during the current school year) since the 1999 Columbine shooting. This brief analyzes the rate of student exposure to school shootings over time at the national and state level. Exposure rates depend on factors including school enrollment size and state population size. Therefore, even a single school…

  • Who Might Lose Eligibility for Affordable Care Act Marketplace Subsidies if Enhanced Tax Credits Are Not Extended?

    Policy Watch

    This analysis looks at the individual market enrollees who make at least four times the federal poverty level who would no longer be eligible for any tax credits if the current ACA Marketplace enhanced subsidies expire at the end of this year. Compared to other people with similar incomes, these enrollees are more likely to be early retirees, self-employed and living in rural areas.

  • What Does the Federal Government Spend on Health Care?

    Issue Brief

    As Congressional Republicans and President Trump search for trillions of dollars in cuts to mandatory federal spending that could help offset the cost of extending expiring tax cuts, this brief analyzes current support from the federal government for health programs and services, including both spending and tax subsidies as context for those federal budget discussions.

  • Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?

    Issue Brief

    This analysis and interactive map illustrate how much more enrollees in Affordable Care Act (ACA) Marketplace plans would pay in premiums at the congressional district level if the enhanced subsidies were to expire in 2026 as under current law. The tool presents scenarios for an older couple who would lose subsidy eligibility due to their income level and for a single person with a $31,000 income. It also presents net average premium payment increases in…

  • Claims Denials and Appeals in ACA Marketplace Plans in 2023

    Issue Brief

    This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for denials is limited, and few consumers appeal claims denials.