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Because states have flexibility in designing their programs, state Medicaid spending and enrollment varies across states. This data note provides an overview of total Medicaid spending per enrollee by eligibility group and state.
This Health Policy 101 chapter provides an overview of the Affordable Care Act (ACA), a major reform of the U.S. health care system aimed at reducing high uninsured rates and alleviating issues like high out-of-pocket costs and coverage exclusions for preexisting conditions. The ACA significantly altered many aspects of the health system and the chapter explores its mechanisms, such as the Health Insurance Marketplaces, and the evolution of the law since its passage in 2010 to the changes in the 2025 budget reconciliation law.
This analysis of preliminary rate filings from 318 insurers across all 50 states and DC finds that small businesses with Affordable Care Act (ACA)-compliant plans could face a median premium increase of 11% for 2026.
This issue brief describes the impact of H.R.1's 10-year delay in implementing provisions in two Medicaid eligibility rules that would have reduced red tape. The delayed rules are projected to decrease federal spending and future Medicaid and CHIP enrollment and increase coverage loss.
The ACA enhanced premium tax credit has driven growth in Marketplace enrollment and offset declines in Medicaid coverage, holding 2024's 8% uninsured rate at its near-historic low, according to new Census Bureau data.
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.
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