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  • Signing Up for Marketplace Coverage Remains a Challenge for Many Consumers

    Policy Watch

    As open enrollment begins for Marketplace plans, this Policy Watch provides information about consumer experiences with Marketplace sign up from the 2023 KFF Consumer Survey. Data from the survey show that Marketplace sign up has been a challenge to many consumers---often more complicated than enrollment in other kinds of health insurance. The Policy Watch also spotlights efforts to address common enrollment problems such as option overload and transitioning to Marketplace coverage from other forms of coverage.

  • Enrollment Growth in the ACA Marketplaces

    Policy Watch

    This analysis of enrollment in Affordable Care Act (ACA) Marketplace health plans finds a record 24.3 million people enrolled in 2025, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election. In six states, enrollment more than tripled from 2020 to 2025: Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee.

  • Who Might Lose Eligibility for Affordable Care Act Marketplace Subsidies if Enhanced Tax Credits Are Not Extended?

    Policy Watch

    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.

  • KFF Health Tracking Poll: ACA Enhanced Subsidies

    Feature

    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.

  • Bar chart shows the estimated 10-year federal spending reductions from delaying implementation of the Biden administration's Medicare Savings Program rule and the Eligibility and Enrollment rule. Delaying these two Medicaid eligibility rules will cut federal spending by $122 billion and increase the uninsured by 400,000 over ten years

    The Impact of H.R. 1 on Two Medicaid Eligibility Rules

    Issue Brief

    This issue brief describes the impact of H.R.1's 10-year delay in implementing provisions in two Medicaid eligibility rules that would have reduced red tape. The delayed rules are projected to decrease federal spending and future Medicaid and CHIP enrollment and increase coverage loss.

  • About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

    About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

    Issue Brief

    This 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 owners and workers spend on their health care.