Enrollment - Research and Data from KFF

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

Sep 10, 2025

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.

State-Based Efforts Will Provide Limited Relief from Enhanced Tax Credit Expiration

Jan 9, 2026

Policy Watch

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.

Medicare Advantage 2026 Spotlight: A First Look at Plan Premiums and Benefits

Dec 9, 2025

Issue Brief

This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.

Analysis Finds Record 3,148 Medicare Advantage Plans Will be Available in 2020

Oct 24, 2019

News Release

A record 3,148 Medicare Advantage plans will be available across the country as alternatives to traditional Medicare, a new KFF analysis finds.

Recent Medicaid/CHIP Enrollment Declines and Barriers to Maintaining Coverage

Sep 24, 2019

Issue Brief

Recently there have been declines in Medicaid and CHIP enrollment, reversing a previous trend of increases following implementation of the ACA. Experiences in some states suggest that renewal process requirements and growing use of periodic eligibility checks may be contributing to disenrollment among people who are still eligible for coverage as well as increased churn in coverage. This brief reviews current rules and state processes related to renewal and periodic eligibility reviews and discusses potential process issues that may be contributing to Medicaid and CHIP enrollment declines.

Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey

Mar 27, 2019

Report

This 17th annual survey of the 50 states and the District of Columbia (DC) provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal, and cost sharing policies as of January 2019.

Medicaid and CHIP Eligibility and Enrollment Policies as of January 2021: Findings from a 50-State Survey

Mar 8, 2021

Report

This report provides data on state Medicaid and CHIP eligibility levels and presents a snapshot of key aspects of state enrollment and renewal procedures in place during the COVID-19 PHE based on information from the 19th annual survey of Medicaid and CHIP program officials in the 50 states and DC.

Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey

Mar 21, 2018

Report

This 16th annual 50-state survey provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2018. It takes stock of how the programs have evolved as the fifth year of implementation of the Affordable Care Act (ACA) begins, discusses policy changes made during 2017, and looks ahead to issues that may affect state policies moving forward. It is based on a survey of state Medicaid and CHIP officials conducted by the Kaiser Family Foundation and the Georgetown University Center for Children and Families. State data are available in Appendix Tables 1-20.

Who can still sign up for 2018 coverage after December 15?

Jan 19, 2018

Fact Sheet

This fact sheet highlights the states and situations where consumers can still sign up for a 2018 marketplace plan even though the Dec. 15 deadline for enrolling in healthcare.gov states has passed. It includes consumers in states who have extended open enrollment periods, people whose 2017 plan was discontinued, and people who live in or moved from counties affected by this year's major hurricanes.

Annual Survey of Medicaid Directors Finds States Continue to Adopt Policies to Respond to the Pandemic and Are Addressing Issues Related to Social Determinants of Health and Health Equity

Oct 27, 2021

News Release

More than 18 months into the COVID-19 pandemic, state Medicaid programs around the country continue to reshape policy in response to the public health emergency and at the same time advance broader initiatives and priorities, including efforts to address the social determinants of health and health equity, finds a new KFF survey.

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