View the Latest: Premiums
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Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2024
Issue BriefThis brief analyzes 2024 Medicare Part D enrollment, premiums, and cost sharing. The analysis highlights the continued growth in Medicare Advantage enrollment in the Part D marketplace and substantially higher average monthly premiums for stand-alone Part D drug plan coverage. Changes to the Part D benefit included in the Inflation Reduction Act are helping to lower out-of-pocket costs for patients but could also contribute to higher-priced Part D coverage.
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Fraud in Marketplace Enrollment and Eligibility: Five Things to Know
Issue BriefThis brief evaluates what is currently known about fraud and abuse in the Affordable Care Act (ACA) Marketplace, including how the final Marketplace Integrity and Affordability Rule and the recently enacted budget reconciliation law change existing Marketplace enrollment and eligibility standards.
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Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces
Policy WatchThe House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.
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Examining Short-Term Limited-Duration Health Plans on the Eve of ACA Marketplace Open Enrollment
Issue BriefAs Marketplace Open Enrollment nears, policy changes could leave millions of people facing substantially higher premiums and coverage loss, which could lead more consumers to purchase less expensive and less comprehensive coverage through short-term health plans. KFF analyzes short-term health policies sold by nine large insurers in 36 states, examining premiums, cost sharing, covered benefits, and coverage limitations and comparing them to ACA Marketplace plans.
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ACA Marketplace Premium Payments Would More than Double on Average Next Year if Enhanced Premium Tax Credits Expire
Issue BriefKFF estimates that, if Congress does not extend the enhanced premium tax credits, ACA Marketplace enrollees on average would see their premium payments more than double in 2026, growing by 114%, from an average of $888 in 2025 to $1,904 in 2026.
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About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed
Issue BriefThis 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…
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Medicare Advantage 2026 Spotlight: A First Look at Plan Premiums and Benefits
Issue BriefThis brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.
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Poll: 1 in 3 ACA Marketplace Enrollees Say They Would “Very Likely” Shop for a Cheaper Plan If Their Premium Payments Doubled; 1 in 4 Say They “Very Likely” Would Go Without Insurance
News ReleaseIf the amount they pay in premiums doubled, about one in three enrollees in Affordable Care Act Marketplace health plans say they would be “very likely” to look for a lower-premium Marketplace plan (with higher deductibles and co-pays) and one in four would “very likely” go without insurance next year, finds a new survey of Marketplace enrollees fielded shortly after open enrollment began in the first weeks of November. The survey captures the views and…
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The New ACA Repeal and Replace: Health Savings Accounts
Policy WatchProposals from some Republicans in Congress would effectively repeal some or all of the ACA premium tax credits and replace them with contributions to Health Savings Accounts (HSAs) or something similar. Senator Rick Scott proposes “Trump Health Freedom Accounts” and Senator Bill Cassidy proposes HSA contributions available only for people who enroll in bronze level ACA plans to pay for out-of-pocket health care costs.