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Affordable Care Act

The Enhanced Premium Tax Credits

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 Employees or Self-Employed and Could Face Higher Premiums Soon

About half (48%) of adults with ACA Marketplace coverage are employed by small businesses or are self-employed and could face higher premiums soon. Because the vast majority of individual market 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.

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ACA Marketplace Plans Nationally Are Seeking a Median 18% Premium Increase for 2026

This analysis of insurers’ initial rate filings for Affordable Care Act Marketplace plans in all 50 states and DC finds the median proposed increase for 2026 is 18%, more than double last year’s proposed increase. The analysis also shows proposed rate changes by state and insurer.


Tariffs Are Driving up Premiums for Small Businesses

Estimates of Additional Uninsured People Across the States

ACA Provisions in the 2025 Federal Budget Reconciliation Law

Health Insurance Marketplace Calculator

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  • How Will the Uninsured in Colorado Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Colorado, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Colorado are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

  • How Will the Uninsured in Texas Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Texas, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Texas are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

  • A Guide to the Supreme Court’s Review of the Contraceptive Coverage Requirement

    Issue Brief

    This issue brief dissects the issues raised by the legal challenges to the Affordable Care Act’s requirement that private insurance plans include contraception as part of their coverage of preventive services for women. Over 40 for-profit corporations and over 40 nonprofit corporations have filed lawsuits claiming that the requirement to provide their employees with contraceptives violates their religious rights. On November 26, 2013, the Supreme Court agreed to hear two cases filed by for-profit corporations, Hobby Lobby and Conestoga Wood Specialties, that claim that this requirement violates their religious rights. At the crux of these cases is a question that the Supreme Court has not previously addressed: Do for-profit corporations have religious protections under the 1993 Religious Freedom Restoration Act and the First Amendment? The brief provides background on how the ACA’s contraceptive requirement works, summarizes some of the legal challenges brought by for-profit and non-profit organizations and discusses the implications of potential rulings by the Supreme Court.

  • Data Note: Attempting to Measure Early Impact of the ACA through National Public Opinion Polls- A Note of Caution and What to Watch For

    Feature

    After the October start of open enrollment, under the Affordable Care Act, many journalists, policymakers, and the public at large are eager for early data indicating how the law is working from the perspective of potential enrollees. In particular, given the problems with Healthcare.Gov and some of the state exchange websites, many people want quantitative data about people’s experiences attempting to purchase or enroll in some sort of health insurance coverage using these mechanisms.
    This Data Note raises a note of caution about the possible pitfalls of using standard national public opinion polls to make judgments about Americans’ early experiences with health plan enrollment under the ACA.

  • Healthy Indiana Plan and the Affordable Care Act

    Fact Sheet

    This fact sheet provides an overview of the Healthy Indiana Plan, Indiana's 1115 waiver demonstration project, and how it relates to the Affordable Care Act's Medicaid expansion.

  • 2023 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2023 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).

  • A Look At CBO Projections For Medicaid and CHIP

    Issue Brief

    This brief examines the latest Congressional Budget Office (CBO) projections for federal Medicaid and CHIP spending over the 2014-2024 period. CBO’s budget projections, also known as “baseline” projections, reflect CBO’s best judgment about how the economy and other factors will affect federal revenues and spending under existing laws. The brief also examines CBO estimates of the coverage effects of the Affordable Care Act (ACA) on Medicaid and CHIP enrollment and spending. Understanding the CBO baseline estimates is important because they are the basis to evaluate the federal cost and coverage implications of proposed federal policy changes.