President Donald Trump and Republicans in Congress pursued several major efforts to repeal and replace the Affordable Care Act (ACA) but were unable to get a bill through the U.S. Senate in 2017. In 2018, Congress did pass a tax bill that eliminated the ACA’s tax penalty for not obtaining health coverage beginning in 2019. The Trump Administration’s actions and decisions also have affected the ACA marketplaces and will continue to reshape how Americans get health insurance into 2019 and beyond.

For information about ACA Marketplace Open Enrollment, including fact sheets and 300+ FAQs, visit our collection of resources on Understanding Health Insurance.

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Individual Insurance Market Performance in 2018

Individual market insurers are expecting to return to consumers a record total of about $800 million in medical loss ratio rebates for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date. Financial results for 2018 suggest that insurers in the individual market are generally returning to or exceeding profitability levels seen before 2014, when ACA insurance market rules took effect, including the requirement to cover people with pre-existing conditions.

Poll Finds Most Americans Oppose the Trump Administration’s Changes to Restrict Title X Family Planning Funds from Clinics that also Provide or Refer for Abortion

A new KFF poll of the public’s views on reproductive health issues finds most Americans, including majorities of women of reproductive age, are concerned that access to women’s reproductive health and preventive care services may be limited by the Trump administration’s changes to Title X, the nation’s federal family planning…

KFF Poll: Public Opinion and Knowledge on Reproductive Health Policy

The latest KFF Poll examines the public’s attitudes towards different facets of reproductive health care in light of recent policy changes made by the Trump administration. This poll examines attitudes towards major changes to the Title X program and attitudes toward state-level laws restricting abortions after a fetal heartbeat has been detected. The poll also looks at public awareness of provisions related to women’s health that are part of the 2010 Affordable Care Act.

KFF Health Tracking Poll – April 2019: Surprise Medical Bills and Public’s View of the Supreme Court and Continuing Protections for People With Pre-Existing Conditions

The April 2019 KFF Health Tracking Poll examines the public’s position on the future of ACA and its protections for people with pre-existing medical conditions, in light of the ongoing legal battle which may end up in the Supreme Court. With lawmakers proposing legislation to address surprise medical bills, this month’s survey also measures the public’s support for federal government action to protect patients from having to pay the cost incurred from an inadvertent out-of-network provider.

How Affordability of Health Care Varies by Income among People with Employer Coverage

This analysis for the Peterson-Kaiser Health System Tracker uses information from the Current Population Survey to look at the average amounts and the shares of family income people in working families with employer-based coverage pay out-of-pocket toward their premiums and direct payments for medical care. It finds that lower income families spend a greater share of their income on health costs than those with higher incomes, and that health status of family members is associated with higher out-of-pocket expenses. 

KFF Health Tracking Poll – March 2019: Public Opinion on the Domestic HIV Epidemic, Affordable Care Act, and Medicare-for-all

This poll explores the public’s attitudes towards, and experiences with, HIV/AIDS in the U.S. in light of President Trump’s announcement of his plan to significantly reduce new HIV infections in the U.S. within ten years. The poll also probes the public on why they may support or oppose a national health plan and find that people’s responses tend to echo the messages emphasized by both sides of the debate.

Poll: Most Americans Say HIV Is Serious Issue for the Country as Trump Administration Rolls Out New Plan to End HIV by 2030; Black and Hispanic Adults Report More Personal Concern than White Adults

Support for Medicare-for-all Holds Steady With the Trump administration launching a new domestic HIV effort, the latest KFF Health Tracking Poll finds a large majority of Americans (80%) view the HIV epidemic as a serious national issue, including a third (34%) who view it as “very serious.” Nearly half (46%) view…

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid

In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.5 million poor uninsured adults are in this situation. This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap and discusses the implications of them being left out of ACA coverage expansions.