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The ACA Marketplace

2025 KFF Marketplace Enrollees Survey

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, according to a KFF survey conducted in 2025.

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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.

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  • Are individuals granted deferred action under “Deferred Action for Childhood Arrivals” (DACA) eligible for Medicaid, CHIP, and the health insurance Marketplaces?

    FAQs

    No. Some individuals who entered the U.S. as children have been given temporary permission to stay in the United States under a program called Deferred Action for Childhood Arrivals (DACA). These individuals are lawfully present in the United States and can be granted work authorization and Social Security numbers. However, DACA recipients are no longer eligible for health coverage through Medicaid, CHIP, or the Marketplaces. Browse more questions in the Marketplace Basics section.

  • Will getting health insurance through Medicaid, CHIP, or the health insurance Marketplaces affect an individual’s ability to obtain lawful permanent resident status or citizenship?

    FAQs

    Some people who apply for a green card (lawful permanent residence) or a visa to enter the U.S. must pass a “public charge” test, which looks at whether the person is likely to become primarily dependent on the federal government as demonstrated by the use of cash assistance programs for income maintenance or government-funded institutionalized long-term care. In making this determination, immigration officials consider certain factors in their totality, including a person's age, family status, income…

  • Does being lesbian, gay, bisexual, or transgender (LGBT) affect my health insurance coverage and options? What if I am married to my same-sex partner?

    FAQs

    You cannot be turned away or charged more for being lesbian, gay, bisexual, or transgender. You also can’t be denied coverage or charged more because of any pre-existing health condition, such as HIV status. Insurers can’t have any annual or lifetime limits on how much they’ll spend on your medical care. Additionally, health programs that receive federal funding, such as Marketplace plans, Medicaid, and Medicare, cannot discriminate based on sex. Notably, though, the legal landscape is evolving.…

  • Do Marketplace plans or Medicaid cover abortions?

    FAQs

    It depends on where you live and what type of coverage you have. For Marketplace plans, there is no federal requirement for plans to cover abortion. About half of states prohibit Marketplace plans from covering abortion. However, other states require plans to cover abortion services and do not permit cost sharing. For Medicaid enrollees, federal law only allows the use of federal funds for abortion in cases of rape, incest, or life endangerment of the pregnant…

  • Does my health plan have to cover all birth control methods with a prescription? Do I have to pay a copay?

    FAQs

    Most employer plans and all Marketplace plans must cover at least one form of all FDA-approved, granted, or cleared birth control (“contraceptive”) services and supplies for women, without cost sharing. This includes sterilization services, insertion and removal of long-acting reversible birth control methods, and follow-up services. While some birth control methods are available over the counter without a prescription, plans typically require a prescription to trigger coverage. Though it is up to an insurer’s discretion,…

  • When can I apply for Marketplace premium tax credits when other coverage is available?

    FAQs

    In general, if you have or are offered other comprehensive, affordable coverage, you may not be eligible for premium tax credits on the Marketplace. However, there are several circumstances where you may be eligible. This chart lays out examples of different coverage types and whether or not they will disqualify you for premium tax credits.

  • Is there any reason the Marketplace wouldn’t automatically adjust and continue my premium tax credit at renewal time?

    FAQs

    Yes. If you live in a state that uses HealthCare.gov, when you first applied for coverage, you had the opportunity to authorize the Marketplace to check online income data about you, including from your tax returns, for another 1 to 5 years. If you did not authorize this, your financial assistance will NOT be automatically continued for next year and you will have to re-apply for financial assistance in order to keep receiving it. If…

  • Do Marketplace plans cover dental care?

    FAQs

    It depends on your age. Dental coverage for children ages 18 and under is an "essential health benefit," meaning it must be available to any children you have, either as part of a health plan or through a separate dental plan, though you are not required to buy it. Dental coverage for adults is not considered an essential health benefit, so Marketplace plans don’t have to offer it.

  • 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…