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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.

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.

ACA Marketplaces

Competition Has Increased in the Individual Market But Fallen in Fully Insured Group Markets

Commercial health insurance markets remain highly concentrated across coverage types. However, the individual market, which consists mostly of the ACA Marketplaces, has attracted more insurers and witnessed greater insurer competition across a variety of measures since the implementation of the enhanced premium tax credits in 2021, according to a new Healthy System Tracker analysis.


ACA Premium Payment Increases Across Congressional Districts

Some Price-Sensitive Consumers May Consider Switching to Short-Term Plans

Marketplace Enrollment Snapshot for Open Enrollment 2026

Number of Insurers in the Individual Insurance Marketplaces

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  • Ensuring the Health Care Needs of Women: A Checklist for Health Exchanges

    Issue Brief

    To inform the development of the state health insurance Exchanges under the Affordable Care Act, this checklist identifies key coverage, affordability and access issues that are important for women. Based on lessons learned from women’s health research and the Massachusetts experience, the checklist considers essential health benefits, implementation of no-cost preventive services including contraception, provider networks and affordability, outreach and enrollment efforts, and the importance of including gender and other demographic characteristics in data collection and reporting standards.

  • Testimony: Wellness Programs and Nondiscrimination Under Employer-Sponsored Group Health Plans

    Issue Brief

    This testimony by the Foundation's Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.

  • Getting into Gear for 2014: Insights from Three States Leading the Way in Preparing for Outreach and Enrollment in the Affordable Care Act

    Issue Brief

    This report provides insight into preparations in Maryland, Nevada, and Oregon -three states that have established a State-based Marketplace, are moving forward with the Medicaid expansion, and are among the states leading the way in preparing for outreach and enrollment. e findings provide an overview of where these three states are in establishing their Marketplaces; preparing for the Medicaid expansion; planning for marketing, outreach and enrollment; and establishing enrollment assistance resources. It highlights the challenges the states have encountered and overcome, the successes they have achieved, and provides key lessons that may help inform implementation efforts moving forward.

  • Medicaid Expansion Through Marketplace Premium Assistance

    Fact Sheet

    This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

  • Getting into Gear for 2014: An Early Look at Branding and Marketing of New Health Insurance Marketplaces

    Issue Brief

    Based on a review of publicly available materials as of September 2013, this brief provides an examination of the Marketplace branding strategies, websites, and marketing materials, providing insight into how consumers will be introduced to the Marketplaces and some of the key messages and approaches the Marketplaces will utilize to encourage individuals to enroll. As of September 2013, states and the federal government are on the eve of their October 1st launch of open enrollment for the new Health Insurance Marketplaces, where consumers will be able to shop for and purchase private coverage and potentially receive subsidies to lower the cost of that coverage. Achieving adequate enrollment through these Marketplaces will be important for fulfilling the Affordable Care Act’s (ACA’s) goal of reducing the nation’s uninsured rate. Moreover, sufficient enrollment, particularly among younger and healthy individuals, will be important for ensuring the financial sustainability of the Marketplaces over time. Recognizing the importance of enrollment, the federal government and the 17 states operating State-based Marketplaces have invested resources and conducted extensive consumer research to inform the branding and marketing campaigns for their Marketplaces.