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The Enhanced Premium Tax Credits

About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

About Half of Adults with ACA Marketplace Coverage are Small Business Employees or Self-Employed and Could Face Higher Premiums Soon

About half (48%) of adults with ACA Marketplace coverage are employed by small businesses or are self-employed and could face higher premiums soon. Because the vast majority of individual market coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.

New and noteworthy

ACA Marketplace Plans Nationally Are Seeking a Median 18% Premium Increase for 2026

This analysis of insurers’ initial rate filings for Affordable Care Act Marketplace plans in all 50 states and DC finds the median proposed increase for 2026 is 18%, more than double last year’s proposed increase. The analysis also shows proposed rate changes by state and insurer.


Tariffs Are Driving up Premiums for Small Businesses

Estimates of Additional Uninsured People Across the States

ACA Provisions in the 2025 Federal Budget Reconciliation Law

Health Insurance Marketplace Calculator

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  • Medicaid Changes in Better Care Reconciliation Act (BCRA) Go Beyond ACA Repeal and Replace

    Issue Brief

    Both the Senate's Better Care Reconciliation Act of 2017 (BCRA) and the House's American Health Care Act (AHCA) go beyond repeal and replacement of the Affordable Care Act (ACA) to make fundamental changes to Medicaid by setting a limit on federal funding through a per capita cap or block grant. The BCRA also includes additional changes that would further reduce federal spending for states with high per enrollee spending, limit state financing mechanisms, allow states to impose work requirements, and make other eligibility changes. Across the board, these changes would have significant implications for the 74 million people covered by the Medicaid program and for states that jointly finance and administer the program. This brief explains the five most significant Medicaid changes in the BCRA as well as additional Medicaid changes that could have major implications for states, providers, and beneficiaries.

  • Senate Health Bill Proposes Big Changes to Medicaid Beyond Repealing and Replacing the ACA

    News Release

    The Better Care Reconciliation Act (BCRA) under consideration in Congress includes provisions that would fundamentally change Medicaid by phasing out extra federal funding for states’ Medicaid expansions and for the first time limiting federal spending on Medicaid through a per enrollee cap on financing or a block grant for certain adults.

  • Using Medicaid to Wrap Around Private Insurance: Key Questions to Consider

    Issue Brief

    This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA's Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.

  • It’s Not Obamacare Anymore. It’s Our National Health-Care System.

    From Drew Altman

    In this Washington Post op-ed, Drew Altman and Larry Levitt discuss why the latest Republican effort to repeal and replace the Affordable Care Act failed and what it will take for congress and the administration to address the next challenge, providing long-term stability to the ACA marketplaces.

  • What Might a Repeal of the Affordable Care Act Mean for Medicare?

    News Release

    As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief.

  • Kaiser Health Tracking Poll: Health Care Priorities for 2017

    Feature

    The most recent Kaiser Health Tracking Poll finds that health care is among the top issues, with the economy and jobs and immigration, Americans want President-elect Donald Trump and the next Congress to address in 2017. As Congressional lawmakers make plans for the future of the Affordable Care Act, the latest survey finds the public is divided on what they would like lawmakers to do when it comes to the 2010 health care law with similar shares saying the next Congress should vote to repeal the law (49%) as saying that it should not vote to repeal it (47%).

  • The Health Care Plan Trump Voters Really Want

    From Drew Altman

    In a New York Times op-ed, Drew Altman draws on observations from focus groups in rust belt states of people in the Affordable Care Act (ACA) marketplaces who voted for President-elect Trump and say they may not like their coverage under the ACA but could like Republican replacement plans even less.