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The Enhanced Premium Tax Credits

Enrollees Making Above 400% of Poverty Will Lose All Financial Assistance Without the ACA’s Enhanced Premium Tax Credits

Premium Payments if the ACA Enhanced Premium Tax Credits Expire

This data note examines how the expiration of the ACA's enhanced premium tax credits could affect the out-of-pocket portion of premiums for different households. KFF’s newly updated tax credit calculator allows Marketplace enrollees to compare how their out-of-pocket premium payments could differ if lawmakers extend the ACA’s enhanced premium tax credits or allow them to expire this year.

New and noteworthy

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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  • Current Flexibility in Medicaid: An Overview of Federal Standards and State Options

    Issue Brief

    The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would have significant implications. To help inform discussion around increased flexibility, this brief provides an overview of current federal standards and state options in Medicaid and how states have responded to these options in four key areas: eligibility, benefits, premiums and cost sharing, and provider payments and delivery systems.

  • Overview of Medicaid Per Capita Cap Proposals

    Issue Brief

    The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per capita cap or block grant have been proposed before. Such changes represent a fundamental change in the financing structure of the program with major implications for beneficiaries, providers, states and localities. Key things to understand about a per capita cap include the following: how a per capita cap works, key design challenges, and implications of a per capita cap.

  • An Overview of Actions Taken by State Lawmakers Regarding the Medicaid Expansion

    Fact Sheet

    The ACA Medicaid expansion has garnered different responses from statelawmakers - Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.

  • State Fiscal Conditions and Medicaid: 2014 Update

    Issue Brief

    This issue brief provides an overview of Medicaid financing, Medicaid’s role in state budgets, the relationship between Medicaid and the economy and how the ACA and the Medicaid expansion could affect state budgets.

  • The Role of Medicaid in State Economies and the ACA

    Issue Brief

    This brief summarizes findings from 32 studies in 26 states analyzing the anticipated impact of the Affordable Care Act Medicaid expansion (and in some cases full ACA implementation) on state and local economies.

  • The Cost of Not Expanding Medicaid

    Report

    As states wrap up legislative sessions and make decisions about whether to implement the Medicaid expansion included in the Affordable Care Act (ACA), this new analysis highlights the implications of these decisions for coverage, state budgets and providers. The decisions by as many as 27 states not to adopt the Medicaid expansion will leave a many more uninsured; these states would also forgo billions in federal funds.

  • Quick Take: Key Considerations in Evaluating the ACA Medicaid Expansion for States

    Fact Sheet

    A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges.  Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion.