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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.

New AND NOTEWORTHY

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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  • “Partial Medicaid Expansion” with ACA Enhanced Matching Funds: Implications for Financing and Coverage

    Issue Brief

    The Affordable Care Act (ACA) provides enhanced federal matching funds to states that expand Medicaid to nonelderly adults up to 138% of the federal poverty level (FPL, $17,236/year for an individual in 2019). The ACA enhanced match (93% in 2019, and 90% in 2020 and thereafter) is substantially higher than states’ traditional Medicaid matching rate. A few states have sought Section 1115 demonstration waiver authority from the Centers for Medicare and Medicaid Services (CMS) to…

  • Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age

    News Release

    As the Trump Administration and Congress weigh policy options to address high prescription drug prices, a fourth of people taking prescription drugs (24%) and seniors taking drugs (23%) say it is difficult for them to afford their medications, the latest KFF Health Tracking Poll finds. The groups most likely to report difficulties affording their medications include people with monthly drug costs of $100 or more (58%), in fair or poor health (49%), with annual incomes less than $40,000 (35%),…

  • About 1 in 6 Emergency Visits and Hospital Stays Had At Least One Out-of-Network Charge in 2017

    News Release

    In roughly 1 of every 6 emergency room visits and inpatient hospital stays in 2017, patients came home with at least one out-of-network medical bill, a new KFF analysis finds. More specifically, 18 percent of all emergency visits and 16 percent of in-network hospital stays had at least one out-of-network charge, leaving patients at risk for surprise medical bills, according to the analysis of claims data from large employer plans. The analysis also finds the…

  • Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults

    Issue Brief

    This issue brief answers 3 key questions and provides new data about state medical frailty determinations, which are assuming greater importance as more states adopt restrictive Section 1115 waivers that exempt medically frail enrollees from policies such as work requirements and premiums. The findings are excerpted from our 50-state survey on Medicaid financial eligibility for seniors and people with disabilities.

  • Analysis: ‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

    News Release

    A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans. An even larger share (31%) could be affected when workers’ voluntary contributions to Flexible Spending Accounts are taken into account. The analysis comes as some in Congress are proposing to repeal the ACA’s tax on high-cost health plans,…

  • State Actions to Improve the Affordability of Health Insurance in the Individual Market

    Issue Brief

    A number of states have taken steps to provide consumers with more affordable coverage options in the individual market, including the marketplaces. Some states are implementing strategies that lower premiums by building on, and increasing the stability of the individual market, while other states are expanding the availability of lower cost coverage sold outside the marketplaces that does not comply with ACA standards—an approach that could increase marketplace premiums further. This brief examines these different…

  • Benchmark Employer Survey Finds Average Family Premiums Now Top $20,000

    News Release

    Annual family premiums for employer-sponsored health insurance rose 5% to average $20,576 this year, according to the 2019 benchmark KFF Employer Health Benefits Survey released today. Workers’ wages rose 3.4% and inflation rose 2% over the same period. On average, workers this year are contributing $6,015 toward the cost of family coverage, with employers paying the rest.

  • Nearly 54 Million Americans Have Pre-Existing Conditions That Would Make Them Uninsurable in the Individual Market without the ACA

    News Release

    Almost Half of Non-Elderly Families have At Least One Adult with a Pre-Existing Condition An updated KFF analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. The share of adults under 65 with such declinable pre-existing conditions varies significantly across states, from at least…