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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.

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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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  • The Biggest Rollback in Federal Support for Health Coverage Ever

    Quick Take

    Republicans are not talking about repealing and replacing the ACA anymore, and the budget reconciliation bill doesn't do that, at least not directly. However, the bill would restrict health insurance for many people who have been helped by the ACA, and it would be the biggest rollback in federal support for health coverage ever.

  • Making the Marketplaces Great Again?

    From Drew Altman

    In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."

  • KFF Health Tracking Poll: The Public’s Views of Funding Reductions to Medicaid

    Feature

    As Congress works to pass the "One Big Beautiful Bill Act," which includes significant changes to Medicaid and the ACA, the latest KFF Health Tracking Poll examines the views of groups that could be most directly impacted by the impending legislation. The poll finds most of the public is worried about the consequences of federal funding reductions to Medicaid, including rural residents, those with lower incomes, and across partisans.

  • How Much More Would People Pay in Premiums if the ACA’s Enhanced Subsidies Expired?

    Interactive

    With the enhanced subsidies for enrollees in ACA Marketplace plans set to expire at the end of 2025, this calculator illustrates how much out-of-pocket premiums would increase if Congress does not extend the subsidies. It shows the projected premium increases based on incomes, zip code, family size and ages based on 2025 ACA Marketplace premiums.

  • 2024 Calculadora del Mercado de Seguros Médicos

    Feature

    2024 Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés).