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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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  • Can I buy or change private health plan coverage outside of Open Enrollment?

    FAQs

    In general, you can have a special enrollment period (SEP) to sign up for Marketplace coverage during the year, other than during Open Enrollment period, if you have a qualifying event. Some examples of qualifying events include marriage, gaining a dependent, or loss of employment. Only one person in a household applying for coverage or financial assistance through the Marketplace must qualify for an SEP in order for the entire household to qualify for the…

  • When can small employers enroll in coverage through the SHOP Marketplace?

    FAQs

    Small employers can buy coverage for their employees through the SHOP Marketplace at any time during the year. HealthCare.gov no longer operates a SHOP Marketplace website for small employers. However, if you want to sponsor small group coverage through the Marketplace for your employees, you can contact insurance companies directly or work with a broker who is certified to sell SHOP policies. In HealthCare.gov states, you can find a SHOP-certified broker using the Find Local Help tool. Be…

  • How long after I enroll in a plan will coverage take effect?

    FAQs

    During Open Enrollment in HealthCare.gov and some other states, if you enroll in a private health insurance plan by December 15 and make your first premium payment by the due date specified by your plan, your new health coverage will start January 1. If you sign up after December 15, your coverage will begin on February 1. If you sign up for a Marketplace plan during a special enrollment period, your coverage will usually take…

  • Can I buy a plan in the Marketplace if I don’t have a green card?

    FAQs

    Potentially, yes. You must be a lawfully present immigrant who is eligible for coverage, such as a lawful permanent resident (green card holder), certain types of visa holders, or a refugee or asylee. Deferred Action for Childhood Arrivals (DACA) is no longer considered an eligible immigration status for health coverage through the Marketplaces. You can find more information about qualifying statuses here.   You can also shop for health insurance outside of the Marketplace in…

  • I’m eligible for health benefits at work, but want to see if I can get a better deal on the Marketplace. Can I do that?

    FAQs

    You can always shop for coverage on the Marketplace, assuming you meet other eligibility requirements, but if you have access to job-based coverage that is determined to be affordable (no more than 9.96% of your household income in 2026), you won’t qualify for premium tax credits. Browse more questions in the Employer-Sponsored Health Coverage and the Marketplace section.

  • Who can buy coverage in the Marketplace?

    FAQs

    Most people can shop for coverage in the Marketplace. To be eligible you must live in the state where your Marketplace is, you must be a citizen of the U.S. or be lawfully present in the U.S., you must not currently be incarcerated, and you cannot currently be enrolled in Medicare. Deferred Action for Childhood Arrivals (DACA) is no longer considered an eligible immigration status for health coverage through the Marketplaces. Not everybody who is…

  • I will lose my employer coverage mid-month. Can my Marketplace coverage start the same month when my old coverage is terminated?

    FAQs

    Yes, your Marketplace coverage will begin the first day of the month after you select your QHP during the special enrollment period triggered by your loss of other job-based coverage. If you sign up for a Marketplace plan during a special enrollment period, your coverage will take effect on the first day of the month after you select your plan, even if you made your selection after the 15th of the month. So, for example,…

  • I learned that my Medicaid coverage has ended. What do I do now?

    FAQs

    If you lose Medicaid but think you still qualify, contact your Medicaid agency. If your coverage ended less than 90 days ago, you may be able to submit any required forms and documents and have your coverage reinstated. If your coverage ended more than 90 days ago, you will likely need to reapply for Medicaid. If the Medicaid agency says you are no longer eligible for Medicaid but you believe that decision was made in…

  • I heard that health plans sold on the Marketplace no longer have to cover certain preventive services. Is that true?

    FAQs

    No, this is not true. Health plans sold on the Marketplace are still required to cover certain preventive services without any patient cost sharing. The categories of preventive services Marketplace plans must cover are: Evidence-based screenings and counseling Routine immunizations Childhood preventive services Preventive services for women Click here for more information on covered preventive services.

  • I’m not sure how long ago my Medicaid ended. Is there a deadline for applying for Marketplace coverage?

    FAQs

    Yes, the special enrollment period due to loss of Medicaid or CHIP is 90 days in most states, which means consumers will have up to 90 days after loss of Medicaid or CHIP to enroll in Marketplace coverage. If you do not apply for Marketplace coverage within this timeframe, you may have to wait until the next Open Enrollment Period to enroll in Marketplace coverage. States that run their own Marketplaces can choose to extend…