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Affordable Care Act

The ACA Marketplace

2025 KFF Marketplace Enrollees Survey

In 2025, about one in three ACA enrollees said they would be “very likely” to look for a lower-premium Marketplace plan If their premium payments doubled.

Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

Following the expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans, a new KFF follow-up survey of the same Marketplace enrollees KFF surveyed in 2025 finds half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, including four in 10 who specifically say their premiums are “a lot higher.”

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POLLING

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.
DATA

Marketplace Enrollment is Down in 2026—But All of the Data Isn’t in Yet

ANALYSIS

Higher Premium Payments or Higher Deductibles: The ACA's Tradeoffs

QUIZ

Test Your Knowledge of the Affordable Care Act

ANALYSIS

Competition Increased in Individual Market But Fell in Fully Insured Group Markets

Timely insights and analysis from KFF staff

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  • Costs, Coverage, and Enrollment Changes: Exploring Current Public Opinion and Policy on the ACA Marketplaces

    Event Date:
    Event

    Following the expiration of the enhanced premium tax credits at the end of 2025, many Americans enrolled in the ACA Marketplaces have faced higher health care costs and reconsidered their coverage options given affordability concerns. To learn more, join KFF public opinion and policy experts for a virtual event focused on the key issues facing ACA Marketplace enrollees and policy considerations, particularly as health care cost and coverage issues rise to the top of voters’ concerns prior to the midterms.

  • After 16 Years, Partisans Still View the Affordable Care Act Very Differently

    Quick Take

    On the 16th anniversary of the Affordable Care Act’s (ACA) passage, most of the public (61%) view the law favorably, though opinions and debates remain as partisan as ever....As voters continue to grapple with the affordability of coverage and care, the partisan legacy of the ACA will almost certainly figure into debates about health care costs this fall.

  • A Note on How the War in Iran May Affect Health Care in the Midterms

    From Drew Altman

    In a new column, Dr. Drew Altman, KFF’s President and CEO, discusses the impact of the war in Iran and rising gas prices on voter concerns about health care costs. He writes: “Recently, we saw health care costs rise to the top of the public’s list of economic worries, ahead of food, housing, utility costs and the cost of gas….Expect gas prices to rise and health care costs to fall on the list of affordability worries while the war in Iran lasts, but then to return to the top or near the top when President Trump decides to declare the major hostilities over, the Strait of Hormuz is open, and gas prices come down….health care costs have staying power as one of the top voter concerns.”

  • ACA Marketplace Survey Feature Image - Website

    Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

    Poll Finding

    This KFF survey is a follow-up survey of adults who had ACA Marketplace insurance in 2025. The survey examines the cost concerns and coverage changes that these 2025 Marketplace enrollees are experiencing following the expiration of the enhanced premium tax credits. The survey finds that half of returning enrollees say their health care costs are “a lot higher” and most expect to cut back on basic household expenses to afford coverage.

  • ACA Marketplace Survey Feature Image - Website

    KFF Follow-Up Survey of Marketplace Enrollees: Following End of Enhanced Credits, Half of Marketplace Enrollees Now Say Costs Are a Lot Higher, Most Expect to Cut Back on Basic Household Expenses to Afford Coverage

    News Release

    Following the expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans, a new KFF follow-up survey of the same Marketplace enrollees KFF surveyed in 2025 finds half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, including four in ten who specifically say their premiums are “a lot higher.”

  • Eight Trends Shaping 2026 Health Care Costs

    Other Post

    A new Peterson-KFF policy explainer lays out the health care trends shaping the 2026 policy debates, including rising premiums, spending on prescription drugs, health care price transparency and consolidation, artificial intelligence in health care, Medicaid funding cuts and other key program changes.

  • Quote from Alina Salganicoff, KFF Senior Vice President and Director for Women’s Health Policy. It says, “The Administration’s latest funding deadline and guidance shift intensifies pressure to the reproductive health safety net at a time when the number of uninsured individuals is projected to rise due to Medicaid cuts and expiration of enhanced Affordable Care Act premium tax credits, and Planned Parenthood clinics have lost their federal Medicaid funding.”

    Navigating Uncertainty: The Latest Challenge to the Title X Family Planning Safety Net

    Quick Take

    The Administration's latest funding deadline and guidance shift intensifies pressure to the reproductive health safety net at a time when the number of uninsured individuals is projected to rise due to Medicaid cuts and expiration of enhanced Affordable Care Act premium tax credits, and Planned Parenthood clinics have lost their federal Medicaid funding.

  • Calculadora del Mercado de Seguros Médicos

    Feature

    Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés).

  • Health Insurance Marketplace Calculator

    Feature

    The Health Insurance Marketplace Calculator, updated with 2025 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).