Individual Market

KFF analysis of Healthcare.gov data from marketplace plans on the federal insurance exchanges shows that despite the changes to the Affordable Care Act in recent years, deductibles for those with low incomes have remained relatively stable since 2017.

The uninsured rate increased in 36 states in 2017, including some that expanded Medicaid. In KFF’s Chart of the Week, explore the uninsured rate increases and decreases for all 50 states.

Overall enrollment in the individual market fell 5% to 13.7 million in the first quarter of 2019 following the repeal of the Affordable Care Act’s individual mandate penalty.

About 88% – nearly nine in ten – enrollees in the individual and fully-insured group markets are covered by plans that have taken action to limit out-of-pocket costs for patients undergoing treatment for COVID-19 since the start of the pandemic. However, after accounting for waivers that have already expired (20%) or are scheduled to expire by the end of September (16%), just over half of enrollees in these plans will still be eligible for waived cost-sharing in October and beyond.

Karen Pollitz answers three questions on the Trump administration’s recent changes to the ACA Section 1332 state innovation waiver guidelines and the implications for consumers and state marketplaces in our new “Ask KFF” feature.

Karen Pollitz, senior fellow for health reform and private insurance at KFF, answers three questions about denied claims and how the federal government may change the data insurers are required to report on this issue.

In 2024, Affordable Care Act (ACA) Marketplace enrollment hit a new record high, reaching over 21 million people. This policy watch discusses the the factors contributing to the increased enrollment in the fastest growing marketplaces.

The states with the fastest recent growth in ACA Marketplace signups also had among the highest uninsured rates previously, as enhanced subsidies helped to make coverage more affordable for many consumers, particularly in southern states that did not expand their Medicaid programs to cover low-income adults, a new KFF analysis…

Open enrollment for the Affordable Care Act (ACA) Marketplaces is about to wrap up with another record high number of people signing up for coverage. Factors that contribute to this increase include unwinding of the Medicaid continuous enrollment, increased subsidies from the American Rescue Plan and Inflation Reduction Act, and increased marketing, outreach, and enrollment assistance.

This analysis of insurers’ preliminary rate filings shows that ACA Marketplace insurers are requesting a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024. Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025.