Affordable Care Act

Enhanced Premium tax credits

2025 KFF Marketplace Enrollees Survey

If their premium payments double, about one in three ACA enrollees say they would be “very likely” to look for a lower-premium Marketplace plan.

Timely insights and analysis from KFF staff

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  • Assessing Americans’ Familiarity With Health Insurance Terms and Concepts

    Poll Finding

    With the approaching launch of the second open enrollment period for the Affordable Care Act’s (ACA) health insurance marketplaces and at a time when open enrollment is also happening for many job-based plans, the Kaiser Family Foundation conducted a nationally representative survey of 1,292 U.S. adults to shed light on Americans’ understanding of basic health insurance terms and concepts, and to identify gaps in awareness that could lead to difficulties for some individuals as they choose new plans or use their health plans.

  • The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs

    Report

    The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015. This report summarizes these federal policies, including the requirements for BHP as well as the methodology for determining federal BHP payments. It then analyzes the key trade-offs facing states as they decide whether and, if so, how to implement BHP, with a particular focus on the impact of BHP on state budgets and the size, stability, and risk level of state marketplaces.

  • More Than Four in Ten Uninsured Don’t Know Basic Health Insurance Terms, Fewer Understand Complex Coverage Concepts

    News Release

    Kaiser Family Foundation Provides Consumer Resources to Fill Knowledge Gaps as the Second Open Enrollment Period Nears for the Affordable Care Act’s Marketplaces With open enrollment for the Affordable Care Act’s health insurance marketplaces days away, findings from a new Kaiser Family Foundation survey suggest that some people who stand to benefit from the law…

  • Estimating Federal Payments and Eligibility for Basic Health Programs: An Illustrative Example

    Report

    In some states, policymakers and stakeholders are considering adoption of the Basic Health Program (BHP) option permitted under the Patient Protection and Affordable Care Act (ACA). Federal regulations allow BHP implementation beginning in 2015. Through BHP, consumers with incomes at or below 200 percent of the federal poverty level (FPL) who would otherwise qualify for subsidized qualified health plans (QHPs) offered in health insurance marketplaces instead are offered state-contracting standard health plans that provide coverage no less generous and affordable than what have been provided in the marketplace. To operate BHPs, states receive federal funding equal to 95 percent of the premium tax credits (PTCs) and cost-sharing reductions (CSRs) that BHP enrollees would have received if they had been covered through QHPs. This paper seeks to inform state-level analysts about the characteristics of BHP-eligible people in their state and how to use that information to estimate the approximate federal BHP payment amount per average BHP-eligible resident.

  • Assessing the Performance of the U.S. Health System

    Issue Brief

    Health spending growth has consistently outpaced U.S. economic growth and is higher than medical spending in other wealthy countries. Despite spending more, the United States doesn't have better health outcome in terms of life expectancy, mortality rates and other measures. This brief provides an overview of trends in health costs and the performance of the U.S. health system, including comparisons to countries from the Organisation for Economic Co-operation and Development (OECD). The brief charts growth in the nation's per capita health spending along with the recent slowdown, touching on the roles of expanded Medicaid eligibility, increases in Medicare beneficiaries and the Affordable Care Act (ACA). Additionally, it discusses the health system's effectiveness and capacity to provide services, including the accessibility and affordability of care.

  • After the Election, the Public Remains Sharply Divided on Future of the Affordable Care Act

    News Release

    Among Those Who Favor Repeal, Arguments About Loss of Coverage for Those with Pre-Existing Conditions Can Sway Some Opinions Many Obamacare Provisions Remain Broadly Popular Across Party Lines, But Not its Mandate The first Kaiser Health Tracking Poll since the 2016 election finds that Americans are largely divided on the future of the Affordable Care…