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.
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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.
Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age.
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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No, your final premium tax credit amount will be determined based on your income for the year as reported on your tax return. The fact that it ended up being less than you expected does not mean you have to repay the advance premium tax credit paid on your behalf, even if you could have qualified for Medicaid. In fact, your final credit amount will likely be larger than the amount you received in advance.…
You can make adjustments during the year whenever you need to. There is no limit to the number of times a person may report income, family, or insurance-eligibility changes to the Marketplace. Changes that you report will be verified by the Marketplace. Then the Marketplace will send you a notice (called a redetermination notice) showing your revised eligibility for premium tax credits and cost-sharing reductions. The adjustment should take effect by the first day of…
When you apply for the premium tax credit, you will be asked to estimate your expected income for the upcoming year. Often a good place to start is to consider what your income is this year, or what income you reported on your tax return last year. However, if your circumstances have changed since then, you should make your best estimate of what your income will be next year. For example, if you recently lost…
It depends on whether she earned enough income to be required to file a federal income tax return on her own. Generally, kids who qualify as tax dependents aren’t required to file a federal income tax return or pay taxes on their income if they earned less than a certain amount ($14,600 in 2025). If your daughter earned less than that, you would not count her income as part of your household income when you…
“Short-term limited-duration” insurance plans are intended to fill a temporary gap in health coverage, such as when someone is between jobs. The maximum duration of short-term plans varies by state. Short-term plans must disclose to consumers that these plans are “NOT comprehensive health coverage.” Short-term plans often do not have the consumer protections found in Marketplace plans. For example, short-term plans can exclude coverage of pre-existing health conditions. Also, many short-term plans do not cover essential health…
Form 1095-A gives you information about the amount of advance premium tax credit (APTC) you received during the previous year. A copy of this form is also reported to the IRS. Keep this form with your other tax records. The APTC you received was based on the annual income you estimated you would earn when you signed up for Marketplace coverage. Now you must file a federal income tax return to compute your actual income for that coverage…
Yes. Premium tax credits can be claimed in advance (during the year) or when you file your taxes. To claim the credit, you will need to file a federal income tax return and Form 8962. Follow the instructions on Form 8962 to determine the amount of tax credit you should receive as a refund when you file your taxes.
If you received an advanced premium tax credit (APTC) through the Marketplace last year, you must file a Form 8962 with your federal income tax return in order to "reconcile" your estimated and actual income for the year, even if you estimated your income perfectly. You can get a blank Form 8962 from the IRS website, or, if you use tax preparation software, the form will be automatically generated for you. The instructions for Form…
Yes. You are required to file a federal income tax return for any year in which you received advanced premium tax credits. When you file, you will have to calculate how much tax credit you were actually eligible for in that year. The Marketplace determination you received last year was based on your good-faith estimate of what your annual income would be. When you file your tax return, you will need two special tax forms: Form 1095-A and Form…
Form 1095-C will indicate your name and the name of your employer, the months when you were eligible for coverage, and the cost to you of the cheapest monthly premium you could have enrolled in under your employer’s health plan. If you worked for a large employer that did not offer its full-time employees health coverage, Form 1095-C will also indicate that. Keep this form with your tax records. You may need this form if…
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