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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.

New and noteworthy

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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  • 5 Ways the Graham-Cassidy Proposal Puts Medicaid Coverage At Risk

    Fact Sheet

    The Graham-Cassidy proposal to repeal and replace the Affordable Care Act (ACA) is reviving the federal health reform debate and could come up for a vote in the Senate before the budget reconciliation authority expires on September 30. This fact sheet describes five ways in which the proposal revamps and cuts Medicaid, redistributes federal funds across states and eliminates coverage for millions of poor Americans.

  • Compare Proposals to Replace The Affordable Care Act

    Interactive

    President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other? Includes the Graham-Cassidy-Heller-Johnson amendment (introduced 9/13/2017) as well as other proposals from key members of Congress.

  • How Single Payer Helps Republicans Change the Subject

    From Drew Altman

    In this Axios column, Drew Altman analyzes the political pros and cons of single payer for Democrats and whether it will shift the focus from the Republicans' failed effort to repeal and replace  the Affordable Care Act to the Democrats new sweeping plan.

  • Medicaid: What We Learned From the Recent Debate and What to Watch for in September 2017

    Issue Brief

    The inclusion of major Medicaid changes in both the American Health Care Act (AHCA) that passed in the House and the Better Care Reconciliation Act (BCRA) considered in the Senate revealed that is hard to gain consensus on significant cuts and reforms to Medicaid. Medicaid has broad general support and intense support from special populations served by the program. In addition, proposed changes would have different implications across states due to significant program variation across states, including implementation of the ACA Medicaid expansion as well as other health status, demographic and state fiscal circumstances.

  • How to Keep ACA Stabilization Narrow

    From Drew Altman

    In this column for Axios, Drew Altman discusses the main challenges for members and media coverage as members take up the issue of stabilization of the Affordable Care Act.

  • Data Note: Strongly Held Views on the ACA

    Feature

    Since the passage of the Affordable Care Act in 2010, Kaiser Family Foundation polling has found the public divided in their overall views of the law. At the same time, an intensity gap in opinion has existed since 2010, with the share of the public holding strongly unfavorable views of the law outnumbering the share with strongly favorable views. A new analysis of Kaiser Family Foundation polling data finds that intensity gap began to close in spring 2017. The share with a “very favorable” view is now roughly equal to the share with a “very unfavorable” view.