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  • About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

    Issue Brief

    This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.

  • Fraud in Marketplace Enrollment and Eligibility: Five Things to Know

    Issue Brief

    This brief evaluates what is currently known about fraud and abuse in the Affordable Care Act (ACA) Marketplace, including how the final Marketplace Integrity and Affordability Rule and the recently enacted budget reconciliation law change existing Marketplace enrollment and eligibility standards.

  • Medicare Advantage in 2025: Enrollment Update and Key Trends

    Issue Brief

    In 2025, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.

  • 8 Things to Watch for the 2026 ACA Open Enrollment Period

    Issue Brief

    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.

  • Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States: House Reconciliation Bill

    Issue Brief

    The Congressional Budget Office’s (CBO) latest estimate shows that the One Big Beautiful Bill would reduce federal Medicaid spending by $793 and that the Medicaid provisions would increase the number of uninsured people by 7.8 million. Previous CBO estimates show that 10.3 million fewer people would be enrolled in Medicaid in 2034. Building on prior KFF analysis, this analysis allocates these estimated federal spending reductions and enrollment losses across the states.

  • A Medicaid Per Capita Cap: State by State Estimates

    Issue Brief

    This analysis examines the potential impacts on states, Medicaid enrollees, and providers of implementing a per capita cap on federal Medicaid spending, which is one proposal that has been discussed in Congress. Such a plan could decrease federal Medicaid spending by $532 billion to almost $1 trillion over a 10-year period, depending on how states respond. An estimated 15 million people could lose Medicaid coverage by 2034.

  • Medicare Advantage 2025 Spotlight: A First Look at Plan Offerings

    Issue Brief

    This brief provides an overview of the Medicare Advantage plans that are available for 2025 and key trends over time. The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, 2 fewer than the 36 options available in 2024. The average Medicare beneficiary can choose among plans offered by 8 firms in 2025, the same as in 2024.