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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.”

new and noteworthy
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

Timely insights and analysis from KFF staff

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  • New Analysis Finds US Individual Insurance Market Grew 46 Percent in First Full Year of Affordable Care Act

    News Release

    A new analysis from the Kaiser Family Foundation finds that the nation's individual insurance market grew 46 percent to 15.5 million people in the first year plans could be purchased through the Affordable Care Act's marketplaces, which offer premium assistance to low- and moderate-income people. Four states -- California, Florida, Texas and Georgia -- accounted for almost half of the enrollment growth. In six states, the number of people covered in the individual market increased…

  • Health Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance

    Issue Brief

    The recession accelerated the long-standing decline in employer-sponsored health insurance and through 2013 most of the recovery in the uninsured rate was due to increased enrollment in public insurance, primarily Medicaid and the Children’s Health Insurance Program (CHIP). With the exception of young adults ages 19 to 25, who are able to remain on their parents’ health plan until age 26 under the ACA, ESI coverage rates for adults and children continued to decrease between…

  • At Tax Time, No Public Backlash Over Obamacare’s Individual Mandate

    News Release

    As tax season closes, Drew Altman looks at why the ACA’s individual mandate and tax credit reconciliation process “passed their first major hurdles this tax season with no significant public backlash,” in his latest column for The Wall Street Journal's Think Tank.

  • At Tax Time, No Public Backlash Over Obamacare’s Individual Mandate

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on April 21, 2015. Tax season has come and gone with no great outbreak of protest about the Affordable Care Act’s least popular provision: the individual mandate. This central element of the ACA was included to help ensure that the individual insurance market would have balanced pools of healthier people and sicker people to help spread insurance risk and keep premiums reasonable. While most of the…

  • Americans’ Views on the Affordable Care Act Hold Steady, with 43% Now Viewing It Favorably and 42% Unfavorably

    News Release

    Few Report Seeing Comparative Information about Health Care Prices and Quality, and Less Than 10% Use It Pocketbook and Consumer Issues Top Public's List of Priorities for the President and Congress, Ahead of Several ACA-Related Issues This month's Kaiser Health Tracking Poll finds public opinion on the health care law holding steady and closely divided. The share expressing a favorable view (43%) exceeds the share with an unfavorable view (42%) for the first time since…

  • Kaiser Health Tracking Poll: April 2015

    Feature

    This month’s Kaiser Health Tracking Poll finds public opinion of the Affordable Care Act (ACA) continues to be almost evenly split The poll also asks about health care priorities for the President and Congress, and the concern that comes out on top for Democrats, Republicans and independents alike is making sure that high-cost drugs for chronic conditions are affordable to those who need them. Other than high-cost prescription drugs, Democrats, Republicans and independents have different…

  • Kaiser Health Policy News Index: April 2015

    Feature

    The health policy stories included in this month’s Kaiser Health Policy News Index were followed closely by about 4 in 10 Americans. Of the stories asked about this month, the one that garnered the most attention was coverage of the white police officer charged with the murder of an unarmed black man in South Carolina. Over half report closely following other stories, including the Germanwings plane crash in the French Alps, a new religious freedom…

  • Coverage of Contraceptive Services: A Review of Health Insurance Plans in Five States

    Report

    The Patient Protection and Affordable Care Act (ACA) requires most private plans to provide coverage for women’s preventive health care, including all prescribed FDA-approved contraceptive services, without cost sharing. To better understand how this provision is being implemented by health plans, Kaiser Family Foundation (KFF) staff, with the Lewin Group, reviewed the insurance plan coverage policies for 12 prescribed contraceptive methods (excluding oral contraceptives). This report presents information from 20 different insurance carriers in five…

  • The Ryan White Program and Insurance Purchasing in the ACA Era: An Early Look at Five States

    Issue Brief

    This issue brief examines the role that the Ryan White Program has played in helping HIV positive clients purchase insurance coverage from both a historical and an Affordable Care Act (ACA) era perspective. The ACA era analysis focuses on activities in five states during the first open enrollment period and looks specifically at insurance purchasing through the health insurance marketplaces. The states analyzed are California, Florida, Georgia, New York, and Texas.

  • Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation

    Issue Brief

    This analysis estimates the range of repayment or refund amounts of the advanced premium tax credits issued to enrollees who experience income volatility between the time of enrollment and tax credit reconciliation. Using a simulation model among all households eligible for advance payments of the premium tax credits under the Affordable Care Act, it estimates that half would owe a repayment while 45 percent would be issued a refund of some or all of premium…