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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"Easy pricing" refers to a "standardized" plan design on HealthCare.gov that aims to make it simpler to compare plans by applying the same to each category of essential health benefits across all easy pricing plans in the same metal level. For example, all Bronze-level easy pricing plans have the same deductible and copays. By contrast, non-standardized Bronze-level plans might have different deductible and copay amounts. Easy pricing plans are marked with a green circle with…
In most states, yes. Generally, an insurer can charge you up to 50% more if you have used tobacco products four or more times per week on average during the past 6 months. This is called a tobacco surcharge. For example, if the premium for somebody your age (before any tax credits are applied) would otherwise be $200 per month, if you are a tobacco user, your premium could be increased to $300 per month.…
Yes, you will be considered as one household when you apply for premium tax credits. However, if your grandchild is eligible for Medicaid or CHIP, you could still purchase coverage for her on the Marketplace, but she would not be eligible for a premium tax credit.
You should contact the Marketplace to notify them of the mistake and request a corrected Form 1095-A. Information on the form is also reported to the IRS, so it is important that you get a corrected form before you file your federal income tax return.
Health insurance companies, certain employer-sponsored health plans, and public health programs such as Medicaid may provide you with documentation indicating the months during the prior year when you were covered under the plan. Coverage providers may send Form 1095-B directly to you, but in some cases, you may have to request a Form 1095-B from the coverage provider. If you were enrolled in family coverage, Form 1095-B will indicate the names of all family members who were…
If you don't update your information with the Marketplace, in most cases, the Marketplace will automatically adjust the amount of your premium tax credit for next year. If that turns out to be less than the amount you’re actually eligible for, you will have to pay more premium each month than you otherwise would have had to, although you can receive a refund for the rest when you file your federal tax return. On the…
You may automatically be re-enrolled in your plan, but even if you like your current plan, it is strongly advised that you take steps to actively renew it during Open Enrollment. If you receive a premium tax credit, when you actively renew you can also update your income and family information and see how much tax credit you may be eligible for based on the new premiums for the coming year. Even if your circumstances…
In general, plans are not required to cover care received from an out-of-network (OON) provider. For example, if you choose to visit a primary care doctor that is not in your plan’s provider network, your insurer might not pay any of the bill, or if they do, you might have much higher cost-sharing than if you had chosen to see an in-network provider. In these situations, the health care provider or facility might send you…
Yes, although the extension is not automatic. In HealthCare.gov states, you must apply for the extra time using an Exceptional Circumstances special enrollment period (SEP). You can apply for this SEP by calling the federal Marketplace call center at 1-800-318-2596. You will have to attest to residing in -- or moving from -- areas affected by a disaster event during an enrollment period you were eligible for. Affected areas are those designated by the Federal…
Yes. You can switch to a different plan at any time during Open Enrollment.
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