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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  • Data Note: Medicaid Managed Care Growth and Implications of the Medicaid Expansion

    Issue Brief

    Most states today rely heavily on risk-based managed care organizations (MCOs) to serve Medicaid beneficiaries. This Data Note discusses the current role of managed care in Medicaid and examines differences in managed care growth between states that expanded Medicaid to low-income adults under the Affordable Care Act (ACA) and states that did not expand Medicaid.

  • Analysis: Insurer Financial Indicators Show Signs of Stabilizing After Transition to ACA Marketplaces

    News Release

    A new Kaiser Family Foundation analysis of key insurer financial indicators suggests that the individual insurance market showed signs of stabilizing in 2016, although profitability remained below the level of performance prior to the opening of the Affordable Care Act’s insurance marketplaces. The new analysis tracks insurer financial performance in the individual market through two key indicators: average medical loss ratios (the share of health premiums paid out as claims) and average gross margins per…

  • Why Trump’s Dealmaking Model Doesn’t Fit Health Care Policy

    From Drew Altman

    In this column as an Axios contributor, Drew Altman discusses President Trump's threat to withhold cost sharing subsidies and questions whether his approach to deal making can bridge health care's partisan and ideological divide. "Health policy is not like real estate," he says.

  • JAMA Forum: Is the Affordable Care Act Imploding?

    Perspective

    In this April 2017 post, Larry Levitt discusses the current status of the Affordable Care Act's health insurance marketplaces, and explains how the Trump administration's choices -- including whether to continue cost-sharing reduction payments to insurers -- could influence stability of the marketplaces going forward. The post is now available at The JAMA Forum.

  • A Warning From the Polls About Letting Obamacare “Explode”

    From Drew Altman

    In this column for Axios, Drew Altman sees a warning for the Trump administration and Republicans in the latest Kaiser Tracking Poll: the more they do to undermine the Affordable Care Act marketplaces the more the public is likely to hold them, and not the Democrats, accountable for the problems with the law.

  • Web Briefing for Journalists – ACA Cost-Sharing Subsidies: How One Decision Could Disrupt Obamacare Marketplaces

    Event Date:
    Event

    Premiums, insurer choice, and overall stability of 2018 Affordable Care Act (ACA) marketplaces could be affected by decisions from Congress and the Trump Administration on the health law’s cost-sharing reduction provision. With a legal appeal pending on a lawsuit from the U.S. House, the federal government and Congress are in a position to choose whether to continue reimbursing insurers for the subsidies, which were established as part of the ACA to reduce out-of-pocket costs for…

  • Estimates: Average ACA Marketplace Premiums for Silver Plans Would Need to Increase by 19% to Compensate for Lack of Funding for Cost-Sharing Subsidies

    News Release

    A new Kaiser Family Foundation analysis finds that the average premium for a benchmark silver plan in Affordable Care Act (ACA) marketplaces would need to increase by an estimated 19 percent for insurers to compensate for lost funding if they don’t receive federal payment for ACA cost-sharing subsidies. Established by the health law to reimburse insurers for the cost of reducing out-of-pocket costs for lower-income people buying marketplace plans (with incomes from 100% to 250%…

  • Three Quarters of the Public, Including a Majority of Trump Supporters, Want President Trump to Try to Make the Affordable Care Act Work

    News Release

    Americans See Many Factors Behind AHCA’s Failure, But Few Republicans Blame President Trump Despite divided views about the Affordable Care Act, three-fourths of the public (75%) say President Trump and his administration should do what they can to make the law work, while one in five (19%), including 38 percent of Republicans, say the Administration should do what it can to make the law fail so they can replace it later, the latest Kaiser Health…