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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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POLLING

Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.
DATA

Marketplace Enrollment is Down in 2026—But All of the Data Isn’t in Yet

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

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  • How Marketplace Costs and Premiums will Change if Rescue Plan Subsidies Expire

    Policy Watch

    In this Policy Watch we explore the potential impact of the expiration of the American Rescue Plan Act’s enhanced financial help and new eligibility for the Affordable Care Act’s health insurance Marketplace federal subsidies. While the COVID-19 relief legislation passed earlier this year provides greater subsidy assistance through 2022, Democrats in Congress are currently considering making the temporary federal help permanent or extending it as part of their planned budget reconciliation legislation.

  • Network Adequacy Standards and Enforcement

    Issue Brief

    Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.

  • Many Women Use Preventive Services, but Gaps in Awareness of Insurance Coverage Requirements Persist: Findings from the 2022 KFF Women’s Health Survey

    Issue Brief

    This brief presents findings from the 2022 KFF Women’s Health Survey on women’s receipt of cancer screenings and other preventive services and differences between subgroups of women. We also present data on women’s and men’s awareness of federal requirements for private insurance coverage of preventive services.

  • Health Insurer Financial Performance in 2024

    Issue Brief

    This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.

  • Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets

    News Release

    A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured group (employer) markets.

  • Standardized Plans in the Health Care Marketplace: Changing Requirements

    Issue Brief

    This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.

  • 2024 Medical Loss Ratio Rebates

    Issue Brief

    Insurers estimate they will pay $1.1 billion in Medical Loss Ratio (MLR) rebates in 2024 to select individuals and employers that purchase their health coverage, according to a KFF analysis of preliminary data reported to state regulators. The estimated rebate for 2024 is larger than rebates issued in most prior years. Nearly $12 billion in rebates have been issued since 2012.

  • Where President-elect Donald Trump Stands on Six Health Care Issues

    Issue Brief

    Where does President-elect Donald Trump stand on key health care issues? This snapshot outlines his positions and policy statements during the campaign on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, and women's reproductive health.