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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.

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  • Explaining the 2015 Open Enrollment Period

    Issue Brief

    The brief provides an overview of what consumers can expect during the second annual Open Enrollment period under the Affordable Care Act (ACA), which runs from November 15, 2014 through February 15, 2015. It is the second opportunity for uninsured individuals to enroll in private insurance coverage, premium tax credits and cost sharing subsidies and the first time that people newly insured in 2014 can renew their health plan coverage and subsidies. It also overlaps with the start of the tax filing season, during which subsidized individuals will undergo tax reconciliation of their 2014 financial assistance and the individual responsibility provisions of the ACA will be enforced.

  • Assessing Americans’ Familiarity With Health Insurance Terms and Concepts

    Poll Finding

    With the approaching launch of the second open enrollment period for the Affordable Care Act’s (ACA) health insurance marketplaces and at a time when open enrollment is also happening for many job-based plans, the Kaiser Family Foundation conducted a nationally representative survey of 1,292 U.S. adults to shed light on Americans’ understanding of basic health insurance terms and concepts, and to identify gaps in awareness that could lead to difficulties for some individuals as they choose new plans or use their health plans.

  • The ACA’s Basic Health Program Option: Federal Requirements and State Trade-Offs

    Report

    The Patient Protection and Affordable Care Act (ACA) gives states the option to implement a Basic Health Program (BHP) that covers low-income residents through state-contracting plans outside the health insurance marketplace, rather than qualified health plans (QHPs). In March 2014, the Centers for Medicare & Medicaid Services (CMS) issued final regulations on the requirements for a BHP and the methodology for calculating federal payments to states. States can choose to implement BHP beginning in 2015. This report summarizes these federal policies, including the requirements for BHP as well as the methodology for determining federal BHP payments. It then analyzes the key trade-offs facing states as they decide whether and, if so, how to implement BHP, with a particular focus on the impact of BHP on state budgets and the size, stability, and risk level of state marketplaces.

  • Challenges to Forecasting Obamacare Enrollment for 2015

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why 2015 enrollment in the Affordable Care Act’s marketplaces is very hard to predict. All previous columns by Drew Altman are available online.

  • How 13 Million Americans Could Lose Insurance Subsidies

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on November 19, 2014. Kaiser Family Foundation calculations of how many Americans could lose subsidies in 2016 depending on the Supreme Court’s ruling in King v. Burwell. The Supreme Court is expected to rule next year on King v.

  • Uncompensated Care for the Uninsured in 2013: A Detailed Examination

    Report

    This report provides estimates of spending for uncompensated care, in 2013, just before implementation of health reform’s major coverage provisions. The report estimates the amount of uncompensated care provided, analyzes the site of care for uncompensated services, and details sources of funding for uncompensated care. These estimates provide an important baseline against which to measure major changes that are occurring under the ACA.