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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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  • The Ryan White Program and Insurance Purchasing in the ACA Era: An Early Look at Five States

    Issue Brief

    This issue brief examines the role that the Ryan White Program has played in helping HIV positive clients purchase insurance coverage from both a historical and an Affordable Care Act (ACA) era perspective. The ACA era analysis focuses on activities in five states during the first open enrollment period and looks specifically at insurance purchasing through the health insurance marketplaces. The states analyzed are California, Florida, Georgia, New York, and Texas.

  • The Pennsylvania Health Care Landscape

    Fact Sheet

    The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Pennsylvania and elsewhere across the country. Pennsylvania is experiencing changes to its health care delivery system as the state expands Medicaid, provides new coverage options through the federal health insurance marketplace, streamlines application and enrollment processes for coverage programs, and implements new health care delivery system and payment reforms. This fact sheet provides an overview of population health, health coverage, and the health care delivery system in Pennsylvania in the era of health reform.

  • Coverage of Contraceptive Services: A Review of Health Insurance Plans in Five States

    Report

    The Patient Protection and Affordable Care Act (ACA) requires most private plans to provide coverage for women’s preventive health care, including all prescribed FDA-approved contraceptive services, without cost sharing. To better understand how this provision is being implemented by health plans, Kaiser Family Foundation (KFF) staff, with the Lewin Group, reviewed the insurance plan coverage policies for 12 prescribed contraceptive methods (excluding oral contraceptives). This report presents information from 20 different insurance carriers in five states (California, Georgia, Michigan, New Jersey, and Texas) about how they are applying reasonable medical management (RMM) techniques in their coverage of women’s contraceptive services. The different forms of female birth control reviewed in this report include the contraceptive ring, the patch, injections, implants, intrauterine devices (IUDs), and sterilization.

  • Medicaid and Family Planning: Background and Implications of the ACA

    Issue Brief

    This brief reviews the role of Medicaid in financing and enabling access to family planning services for low-income women; discusses how states have expanded access to these services with Medicaid; and highlights future programmatic challenges in the context of the health care delivery and coverage reforms resulting from the Affordable Care Act (ACA).

  • Measles Outbreak and Vaccination Debate Capture Public’s Attention

    News Release

    Those Following Measles Story More Likely To Say They Worry About the DiseaseThe public paid more attention to news coverage of the measles outbreak in the U.S. and the resulting debate on whether vaccinations should be required for all kids than any other news story included in this month's Kaiser Health Policy News Index.

  • At Five Year Anniversary of the ACA, Gap Between Favorable and Unfavorable Views Among The Public Narrows to Smallest Spread in More Than Two Years

    News Release

    Most Expect Negative Consequences if Supreme Court Prohibits Subsidies in States Without Their Own Insurance Exchanges; Two Thirds of the Public and Those in Affected States Want Congress or Their State to Close Any Gaps As April 15 Tax Deadline Nears, Nearly Half Unaware Insurance Reporting Requirement Starts This Year Five years after President Obama…

  • Kaiser Health Policy News Index: March 2015

    Feature

    The public paid more attention to news coverage of the measles outbreak in the U.S. and the resulting debate on whether vaccinations should be required for all kids than any other news story included in this month's Kaiser Health Policy News Index. Nearly half correctly identified that the number of confirmed measles cases in the U.S. since the outbreak began late last year is closer to 100, and most say they are not too or not at all worried about the measles outbreak.

  • Kaiser Health Tracking Poll: March 2015

    Feature

    As the Affordable Care Act (ACA) marks its fifth anniversary, this month’s poll finds the gap between favorable and unfavorable opinions of the law has narrowed to the closest margin in over two years. Although the Supreme Court heard oral arguments for the King v. Burwell case in early March, the majority of the public continues to say they have heard only a little or nothing at all about the case. The survey also includes a look at Americans’ experiences reporting their insurance status on their taxes for the first time, and finds that nearly half are unaware that the requirement to report health insurance status on their taxes takes effect this year.

  • Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation

    Issue Brief

    This analysis estimates the range of repayment or refund amounts of the advanced premium tax credits issued to enrollees who experience income volatility between the time of enrollment and tax credit reconciliation. Using a simulation model among all households eligible for advance payments of the premium tax credits under the Affordable Care Act, it estimates that half would owe a repayment while 45 percent would be issued a refund of some or all of premium subsidies received.