Marketplace Insurers are Proposing a 7% Average Premium Hike for 2025 and Pointing to Rising Hospital Prices and GLP-1 Drugs as Key Drivers of Costs August 5, 2024 News Release ACA Marketplace insurers are proposing a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024, according to a new KFF analysis of the preliminary rate filings. Insurers’ proposed rate changes – most of which fall between 2% and 10% – may change during…
How Narrow or Broad Are ACA Marketplace Physician Networks? August 26, 2024 Report This report examines the share of doctors participating in the provider networks of Qualified Health Plans (QHPs) offered in the individual market in the federal and state Marketplaces in 2021, and how network breadth affected costs for enrollees.
KFF Analysis Finds Physician Networks in ACA Marketplace Plans Vary Widely, and Enrollees Typically Pay More in Premiums to Access Broader Networks August 26, 2024 News Release A KFF analysis of physician networks in the Affordable Care Act’s Marketplace plans finds wide variations in the share of local practicing physicians who participate, with the least costly plans generally having a smaller share of physicians than more expensive plans. The analysis examines the breadth of physician networks listed…
How Might Changes to the ACA Marketplace Impact Enrollees with Mental Health Conditions? June 27, 2025 Issue Brief This brief estimates the number of current Marketplace enrollees with a mental health diagnosis to understand what changes in enrollment may mean for access to services. Among the 24.3 million Marketplace enrollees in 2025, over 4.4 million individuals are estimated to have at least one mental health diagnosis on a health care claim.
We’ve Never Seen Health Care Cuts This Big July 1, 2025 Perspective In this July 1 column for The New York Times Opinion section, KFF Executive Vice President for Health Policy Larry Levitt explains how the budget reconciliation bill passed by the Senate on July 1 is effectively a partial repeal of the Affordable Care Act (ACA) and, if signed into law,…
Who Might Lose Eligibility for Affordable Care Act Marketplace Subsidies if Enhanced Tax Credits Are Not Extended? March 3, 2025 Blog This analysis looks at the individual market enrollees who make at least four times the federal poverty level who would no longer be eligible for any tax credits if the current ACA Marketplace enhanced subsidies expire at the end of this year. Compared to other people with similar incomes, these enrollees are more likely to be early retirees, self-employed and living in rural areas.
Individual Market Insurers Requesting Largest Premium Increases in More Than 5 Years July 18, 2025 Issue Brief This analysis of preliminary rate filings submitted by 105 ACA Marketplace insurers in 19 states and DC shows that ACA Marketplace insurers are requesting a median premium increase of 15% for 2026, which would represent the largest hike in premiums since 2018, the last time policy uncertainty contributed to sharp premium growth. The scheduled expiration of enhanced tax credits and impact of tariffs on some drugs, medical equipment, and supplies are among the factors pushing premiums higher
Ask KFF: Karen Pollitz Answers 3 Questions on Trump Administration’s New ACA Waiver Guidelines November 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.
Ask KFF: Karen Pollitz Answers 3 Questions on Why Insurers Deny Claims March 6, 2019 Issue Brief 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.
The Affordable Care Act 101 May 28, 2024 Page 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.