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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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  • Premiums under the Senate Better Care Reconciliation Act

    Issue Brief

    This analysis provides estimates of how premiums, after taking into account tax credits, would differ in 2020 under the Senate's Better Care Reconciliation Act (BCRA) vs. the Affordable Care Act (ACA) for people currently enrolled in the federal and state insurance marketplaces.

  • Media Availability on Senate Health Bill

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call Tuesday, June 27, with key experts to explain the Senate Republican health bill and to answer questions about its implications and the CBO’s scoring of the bill.

  • Association Health Plans for Small Groups and Self-Employed Individuals under the Better Care Reconciliation Act

    Issue Brief

    A provision in the Senate Better Care Reconciliation Act (BCRA), a bill to repeal and replace the Affordable Care Act (ACA), would establish association health plan options for small employers and self-employed individuals. For these plans, the requirement that premiums cannot vary based on health status would not apply. This brief describes how association health plans could affect premiums in the small group and non-group markets.

  • Medicaid’s Role in West Virginia

    Fact Sheet

    This fact sheet provides data on Medicaid's role in West Virginia. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect West Virginia.

  • Medicaid’s Role in Alaska

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Alaska. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Alaska.

  • Section 1332 State Innovation Waivers: Current Status and Potential Changes

    Issue Brief

    Section 1332 of the Affordable Care Act (ACA) authorizes states to waive key requirements under the law in order to experiment with different health coverage models. As Republicans in Congress debate repeal and replacement of the ACA, renewed attention is being paid to these waivers as a mechanism for giving states flexibility to restructure their health care markets. This brief describes current 1332 waiver activity, including proposals in the Senate's Better Care Reconciliation Act (BCRA), and raises questions regarding the future of these waivers, particularly in the context of proposed changes under discussion.

  • Medicaid’s Role in Kentucky

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Kentucky. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Kentucky.

  • Kaiser Health Tracking Poll – July 2017: What’s Next for Republican ACA Repeal and Replacement Plan Efforts?

    Feature

    As the U.S. Senate continues to debate their plan to repeal and replace the ACA, the latest Kaiser Family Foundation tracking poll finds the public souring on the effort with a growing majority opposed to the plan and a large share that say the plan does not fulfill most of the promises President Trump has made about health care. Even among Republicans, the poll finds that about half would be “less likely” to support the Senate health plan if they heard it would increase premiums for most people who purchase their own insurance on the marketplace. In addition, a majority of the public would rather see Republicans in Congress work with Democrats to make improvements to the ACA but not repeal the law. The tracking poll also gauges the public's views on the proposed major reductions in federal funding for Medicaid as well as how these views are affected by counter-arguments.