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.
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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.
Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age.
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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Yes. The American Rescue Plan provides for new, temporary COBRA premium subsidies for people who lost their jobs or had their hours cut so they no longer qualify for group health benefits. The law provides for a 100% premium subsidy for COBRA for up to 6 months. The first subsidy-eligible month is April 2021 and the last subsidy-eligible month is September 2021. Employers will pay the COBRA premium for subsidy-eligible individuals and be reimbursed by…
No. People lose eligibility for the COBRA premium subsidy when they become eligible for other job-based health coverage. You are required to notify your former employer or COBRA administrator if you become eligible for other job-based health coverage. If you do not, you might owe a penalty.
Family premiums will reflect the composition of family members; in most states, this includes their ages and any tobacco use. To calculate a “family premium,” insurers will add together a separate premium for each adult age 21 and older. Insurers can charge a separate premium for up to three children under age 21. For example, if you have four children under age 21, your family premium will reflect two adult premiums and only three child…
Links to all state Marketplaces can be found on HealthCare.gov.
Family members, your church, federal programs such as the Ryan White HIV/AIDS program, or any charity that doesn't condition financial help on health status can pay your premium on your behalf. However, Marketplace plans are discouraged from accepting third-party payments from hospitals and other commercial entities. Some dialysis facilities offer to pay premiums for Medicare-eligible patients with end-stage renal disease who elect Marketplace coverage instead of Medicare. Check with a Marketplace navigator or your State…
No, you will not be required to repay the premium tax credits paid on your behalf when you file your tax return as long as the tax credits were authorized and paid for at least one month during the year. In this situation, if the Marketplace found that your estimated income made you eligible for premium tax credits at the time you enrolled, even though your income later fell below the minimum income eligibility level…
The higher premium subsidies are in effect for the 2021 and 2022 plan years. For premiums you already paid in 2021, before the new law passed, you can claim the increased tax credit when you file your federal income tax return.
Yes. Generally, people must have an annual income at least as high as the federal poverty level in order to qualify for marketplace subsidies. In states that have not expanded Medicaid eligibility, that leaves poor adults with no access to financial help for health coverage. However, during 2021 only, people who receive UI benefits during the year and who live in non-expansion states can receive a premium tax credit and cost-sharing subsidies even if their…
No. If you are eligible for Medicaid you cannot be eligible for marketplace subsidies. Some people who receive UI benefits will be eligible for Medicaid, in part because Medicaid will NOT take into account the $300 per week federal supplemental UI benefits. When you apply through the marketplace, you will receive a determination indicating whether you are eligible for Medicaid. Medicaid coverage is also free or low cost (some states charge a nominal monthly premium…
The special enrollment period due to loss of Medicaid or CHIP is 90 days, which means consumers will have up to 90 days after loss of Medicaid or CHIP to enroll in Marketplace coverage. However, state-based Marketplaces have the option to extend the special enrollment period beyond 90 days. Check with your state Marketplace for more information if you live in one of these states.
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