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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.
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.
In his first column for the new year, KFF CEO Dr. Drew Altman analyzes President Trump’s “make a deal” approach to health care. He explains that while the president doesn’t have a health reform plan, or even “concepts of a plan,” or a replacement for the ACA, he does have a distinctive set of tactics that features one-off deals with the health care industry that are more like “health policy by transaction.” He writes that the deals “even do some good,” but “don’t change the long-term incentives of the health care companies that participate in the deals,” and a big question is “whether they have staying power.”
Policy changes, anticipated increases in premium costs for enrollees, and new standards for health savings accounts may encourage consumers to seek out plans with lower premiums but higher deductibles. This issue brief explores the features of bronze and catastrophic plans, coverage and costs, and the complicated choices consumers face.
With the Affordable Care Act’s (ACA) enhanced premium tax credits set to expire at the end of 2025, a large majority (77%) of the public favor Congress extending the credits while about one in five (22%) say they should let them expire, the latest KFF Health Tracking Poll finds.
In a new column, Dr. Drew Altman, KFF’s President and CEO, discusses the limits of polling on policy, and what we have learned over more than 30 years of polling about how giving people more information and arraying tradeoffs can change opinion, including on the health policy changes and funding cuts in the current reconciliation bill.
KFF's Health Tracking Poll looks at public awareness and support for ACA Marketplace subsidies and finds that most adults are unaware the subsidies are set to expire soon. Three in four say Congress should extend the subsidies and support persists despite hearing counter arguments.
This chart examines individual market enrollment data from 2011 through 2025, when enrollment reached a record high of 25.2 million people. Affordable Care Act (ACA) Marketplace enrollment increased following the enactment of enhanced premium tax credits in 2021, as more individuals became eligible for subsidies.
In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."
In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”
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