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Affordable Care Act Signups Are Down, But Still an Incomplete Picture

Data from CMS may not fully show how much the expiration of the enhanced premium tax credits has affected enrollment in the ACA Marketplaces. The extent of enrollment changes likely won’t be known until this summer, when effectuated enrollment data are typically released.
DATA

Marketplace Enrollment Snapshot for Open Enrollment 2026

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

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.

Updated Larry QT on ePTCs

There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks

A discharge petition in the House paves the way for a vote on a three-year extension of the tax credits, which would provide ACA enrollees premium relief whenever it comes. While there is still time to extend the enhanced tax credits, with each passing day, more and more ACA Marketplace enrollees are going to drop their health insurance when faced with eye-popping increases in their premium payments, writes KFF’s Larry Levitt.

Timely insights and analysis from KFF staff

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  • Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal

    Issue Brief

    This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.

  • 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.

  • Data Note: Gearing Up For Round 2 of Open Enrollment: Some Lessons From Round 1

    Poll Finding

    As the second round of open enrollment approaches, policy makers, journalists, insurers and enrollment groups may want to keep in mind what health insurance shoppers told us about their experiences during the first open enrollment period. This data note examines selected findings from two Kaiser Family Foundation surveys that shed light on how people navigated the new options and choices available under the ACA during last fall’s open enrollment, with the hope of helping to inform our understanding of individuals needs during this second open enrollment period.

  • ACA Advertising in 2014 – Insurance and Political Ads

    Report

    This study analyzes the volume and content of political ads mentioning health care issues that aired in 2014 through Oct. 15, as well as health insurance spots promoting specific insurance products or encouraging enrollment in marketplace plans. It finds that about 14 percent of political ads in all races mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way.

  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election. All previous columns by Drew Altman are available online.

  • An Update on Coverage for Preventive Services Under the Affordable Care Act

    News Release

    An updated fact sheet from the Kaiser Family Foundation summarizes the latest information on health plan coverage of preventive services under the Affordable Care Act. The fact sheet details the rules that govern when plans are required to cover services without cost-sharing and which services are covered.

  • Brief Provides Update on LGBT Coverage and Health as More States Recognize Same-Sex Marriage

    News Release

    An updated issue brief from the Kaiser Family Foundation gives a detailed profile of health concerns for lesbian, gay, bisexual and transgender individuals, offers the latest demographic data, and discusses the impact of recent changes in state and federal policies on health coverage, including the Affordable Care Act and same-sex marriage.

  • Open Enrollment: Insights from Medicare for Health Insurance Marketplaces

    News Release

    In the latest post in the Policy Insights series, Tricia Neuman draws on the experiences of Medicare beneficiaries during Medicare’s annual enrollment period to consider whether consumers with health insurance coverage through the Affordable Care Act’s new marketplaces will shop for a better deal during their open enrollment season. Previous columns in the Policy Insights series are also available on kff.org.

  • The ACA Primary Care Increase: State Plans for SFY 2015

    Perspective

    This perspective provides additional information on state plans related to the Affordable Care Act's (ACA) primary care rate increase after the 100% federal financing ends December 31, 2014. The data in this report were collected as part of KCMU’s Annual Medicaid Budget Survey, conducted by Health Management Associates with the support of the National Association of Medicaid Directors,