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This analysis examines the competitiveness of markets for hospital care and finds that nearly half of metropolitan areas across the country had only one or two hospitals or health systems providing general inpatient hospital care in 2024.
This KFF survey is a follow-up survey of adults who had ACA Marketplace insurance in 2025. The survey examines the cost concerns and coverage changes that these 2025 Marketplace enrollees are experiencing following the expiration of the enhanced premium tax credits. The survey finds that half of returning enrollees say their health care costs are “a lot higher” and most expect to cut back on basic household expenses to afford coverage.
Virtually all (98.9%) of the 2.6 million Medicare beneficiaries enrolled in a Medicare Advantage plan that terminated coverage at the end of 2025 have at least one MA-PD available in 2026, including more than two-thirds (68.7%) who have the option of enrolling in a plan sponsored by the same insurer.
President Trump announced a health care framework that leaves open key questions, including those about out-of-pocket costs, premiums, federal spending, and health coverage for people with pre-existing conditions.
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.
Commercial health insurance markets remain highly concentrated across coverage types. However, the individual market, which consists mostly of the ACA Marketplaces, has attracted more insurers and witnessed greater insurer competition across a variety of measures since the implementation of the enhanced premium tax credits in 2021, according to a new Healthy System Tracker analysis.
This brief provides an overview of the Medicare Advantage plans that are available for 2026 and key trends over time. In 2026, the average Medicare beneficiary has a choice of 32 Medicare Advantage prescription drug (MA-PD) plans, two fewer than the 34 in 2025. Virtually all Medicare Advantage plans for 2026 provide multiple extra benefits like vision, hearing, and dental benefits, similar to last year.
This issue brief provides an overview of the potential impact not extending enhanced ACA premium tax credits could have on people with HIV and the Ryan White HIV/AIDS Program. Enhanced credits have improved insurance coverage affordability for millions of people, including those with HIV. People with HIV may be particularly vulnerable, given that they are more likely to have Marketplace plans and many also rely on the federally-funded Ryan White HIV/AIDS Program to help cover plan costs. Loss of coverage and increased costs could lead to disruptions in care for people with HIV which could have serious implications for individual and public health.
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.
Some insurers in the ACA’s small group market are citing tariffs, particularly those affecting prescriptions drugs, as a reason for higher-than-expected premium increases.
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