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Affordable Care Act Signups Are Down, But Still an Incomplete Picture

Data from CMS may not fully show how much the expiration of the enhanced premium tax credits has affected enrollment in the ACA Marketplaces. The extent of enrollment changes likely won’t be known until this summer, when effectuated enrollment data are typically released.
DATA

Marketplace Enrollment Snapshot for Open Enrollment 2026

ANALYSIS

Higher Premium Payments or Higher Deductibles: The ACA's Tradeoffs

QUIZ

Test Your Knowledge of the Affordable Care Act

ANALYSIS

Competition Increased in Individual Market But Fell in Fully Insured Group Markets

Enhanced Premium tax credits

2025 KFF Marketplace Enrollees Survey

If their premium payments double, about one in three ACA enrollees say they would be “very likely” to look for a lower-premium Marketplace plan.

Updated Larry QT on ePTCs

There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks

A discharge petition in the House paves the way for a vote on a three-year extension of the tax credits, which would provide ACA enrollees premium relief whenever it comes. While there is still time to extend the enhanced tax credits, with each passing day, more and more ACA Marketplace enrollees are going to drop their health insurance when faced with eye-popping increases in their premium payments, writes KFF’s Larry Levitt.

Timely insights and analysis from KFF staff

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  • Short-Term Limited Duration Plans and HIV

    Issue Brief

    Given the Trump Administration’s promotion of short-term limited-duration (STLD) health insurance policies, this brief examines what they mean for people with HIV. The analysis assesses whether people with HIV could enroll in STLD plans by applying to 38 plans across five states and getting in each case. It also assesses whether such plans could meet basic HIV care and treatment needs for someone diagnosed once enrolled. This finding takes on new importance in light of the Administration’s decision not to defend the ACA and to argue for eliminating pre-existing condition protections.

  • KFF/EHF Poll: Texans’ Top State Health Priorities Include Lowering Out-of-Pocket Costs and Reducing Maternal Mortality

    News Release

    Most Texans Don’t Know their State has the Nation’s Highest Uninsured Rate Texans’ top health care priorities for the state revolve around making health care and prescription drugs more affordable, reducing maternal mortality and increasing access to health insurance coverage, finds a new statewide Kaiser Family Foundation/Episcopal Health Foundation survey on Texas health policy issues.

  • Texas Residents’ Views on State and National Health Policy Priorities

    Report

    As part of the new Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texans’ views on health policy priorities at both the state and national level. It examines how Texas residents view state spending on health care and how they rank initiatives such as lowering health care costs, reducing maternal mortality, and funding for mental health care. It also explores Texans’ views on the Affordable Care Act and Medicaid, including personal connections to the Medicaid program and support for Medicaid expansion.

  • 2019 Premium Changes on ACA Exchanges

    Issue Brief

    This tracker monitors preliminary 2019 premiums in the Affordable Care Act’s marketplaces as insurers file rate information with state regulators. It shows preliminary premium information in a major city in each available state for the lowest-cost bronze plan and “benchmark” silver plan, which is used to determine the size of the premium tax credits available to low- and moderate-income enrollees. The tracker also shows how those premiums are changing from 2018 and what a 40-year-old enrollee making $30,000 annually would pay before and after available tax credits.

  • Analysis: Individual Market Insurers Experienced Their Best Financial Year under the ACA in 2017, Though Subsequent Political and Policy Changes Complicate the Outlook for Future Years

    News Release

    Insurers in 2017 had their best financial year selling individual market health insurance since the Affordable Care Act began requiring guaranteed access to coverage for people with pre-existing conditions in 2014, though recent political and policy changes create new challenges for insurers trying to succeed in this market, new Kaiser Family Foundation analysis finds.

  • Individual Insurance Market Performance in 2017

    Issue Brief

    This brief examines recently-released annual financial data from 2017 and finds insurers selling individual market plans had their best financially since 2014, when new ACA insurance market rules took effect that guaranteed access to coverage for people with pre-existing conditions. At the same time, recent political and policy changes, including the repeal of the individual mandate penalty as part of tax reform legislation and proposed regulations to expand loosely-regulated short-term insurance plans, cloud plans’ outlook going forward.