Individual Market - Research and Data from KFF

Two New Analyses: House COVID-19 Relief Plan Would Temporarily Lower Marketplace Premiums for Millions and More than Offset Short-Term State Costs to Expand Their Medicaid Programs

Feb 18, 2021

News Release

The House COVID-19 relief proposal would temporarily lower what millions of Marketplace enrollees and uninsured potential enrollees would pay toward premiums and would provide states that have not expanded their Medicaid programs a financial boost that would more than offset their costs initially, two new KFF analyses find. The analyses assess two parts of the House plan aimed at expanding access to affordable health coverage by expanding the Affordable Care Act’s tax credits for people…

Updated KFF Calculator Estimates Marketplace Premiums to Reflect Expanded Tax Credits in COVID-19 Relief Legislation

Mar 10, 2021

News Release

KFF has updated its 2021 Health Insurance Marketplace Calculator to reflect the expanded premium tax credits available to people who purchase their own coverage through their state’s health insurance exchange as passed by Congress in the American Rescue Plan Act and expected to be signed into law soon. The calculator allows users to enter their age, income, family size, and zip code to assess their eligibility for tax credits and how much they can expect…

36 States Saw Uninsured Rate Increase in 2017, Including Some that Expanded Medicaid

Dec 14, 2018

Feature

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.

Para consumidores que estén considerando planes de salud de corto plazo…

Oct 30, 2018

Fact Sheet

Esta hoja informativa ofrece datos sobre los planes de salud de corto plazo y en qué se diferencian de las pólizas que cumplen con ACA.

Analysis: Individual Market Insurers Experienced Their Best Financial Year under the ACA in 2017, Though Subsequent Political and Policy Changes Complicate the Outlook for Future Years

May 17, 2018

News Release

Insurers in 2017 had their best financial year selling individual market health insurance since the Affordable Care Act began requiring guaranteed access to coverage for people with pre-existing conditions in 2014, though recent political and policy changes create new challenges for insurers trying to succeed in this market, new Kaiser Family Foundation analysis finds. This analysis finds insurers posted their strongest performance in the individual market using two different financial indicators: The average share of…

Some Can Get Marketplace Plans With No Premiums,Though With Higher Deductibles and Cost-Sharing

Nov 26, 2018

News Release

Many low-income consumers who are eligible for federal financial help under the Affordable Care Act can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis from KFF (the Kaiser Family Foundation). Such plans come with higher deductibles and out-of-pocket maximums, however. The analysis finds that the ACA’s premium tax credits would cover the full premium of the lowest-cost bronze…

Ask KFF: Karen Pollitz Answers 3 Questions on Trump Administration’s New ACA Waiver Guidelines

Nov 30, 2018

Issue Brief

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.

Mapping Pre-existing Conditions across the U.S.

Aug 28, 2018

Issue Brief

This brief estimates the share of adults with pre-existing conditions by metropolitan and micropolitan statistical area (MMSA), and finds that in some areas, nearly four in ten have so-called declinable medical conditions that could lead to denials of individual insurance coverage based on pre-ACA underwriting guidelines.

Higher Premium Payments or Higher Deductibles: The Tradeoffs ACA Enrollees Face

Jan 14, 2026

Issue Brief

This Health System Tracker analysis examines the tradeoffs ACA Marketplace enrollees must consider as they decide whether to keep their current plan or switch to a new one, following the expiration of the ACA’s enhanced premium tax credits at the end of 2025.

Claims Denials and Appeals in ACA Marketplace Plans in 2024

Mar 24, 2026

Issue Brief

This brief analyzes federal transparency data published by CMS on claims denials and appeals for Marketplace plan offered on HealthCare.gov in 2024, and finds insurers denied 19% of in-network claims. Consumers rarely appeal denied claims.

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