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The ACA Marketplace

2025 KFF Marketplace Enrollees Survey

In 2025, 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.

Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

Following the expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans, a new KFF follow-up survey of the same Marketplace enrollees KFF surveyed in 2025 finds half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, including four in 10 who specifically say their premiums are “a lot higher.”

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POLLING

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.
DATA

Marketplace Enrollment is Down in 2026—But All of the Data Isn’t in Yet

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

Timely insights and analysis from KFF staff

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  • U.S. Public Opinion on Health Care Reform, 2017

    Feature

    This slideshow supports a Visualizing Health Policy infographic with JAMA, spotlighting public opinion on health reform in the United States as of 2017, including priorities and views of the Affordable Care Act (also known as Obamacare) and its provisions.

  • Data Note: What if Per Enrollee Medicaid Spending Growth Had Been Limited to CPI-M from 2001-2011?

    Issue Brief

    Congress is currently debating the American Health Care Act (AHCA), which would repeal and replace the Affordable Care Act (ACA) and also make substantial changes to the structure and financing of Medicaid. Among other provisions, the AHCA would use a per capita cap policy to cap federal funds to states for Medicaid. This data note examines what the implications of tying per enrollee growth to CPI-M would have been for the 2001-2011 period for federal spending nationally and state-by-state by major enrollment group. This analysis is meant to illustrate how actual spending compares to spending limits that would have been in place if growth rates had been limited to CPI-M, similar to the limits proposed by the AHCA.

  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

  • A Warning From the Polls About Letting Obamacare “Explode”

    From Drew Altman

    In this column for Axios, Drew Altman sees a warning for the Trump administration and Republicans in the latest Kaiser Tracking Poll: the more they do to undermine the Affordable Care Act marketplaces the more the public is likely to hold them, and not the Democrats, accountable for the problems with the law.

  • Medicaid Family Planning Programs: Case Studies of Six States After ACA Implementation

    Report

    In light of the coverage trends and other ACA-related changes, this paper describes the impact on women and their partners, as well as family planning providers, of the impact of family planning expansion programs under Medicaid. It is based largely on interviews with state officials, providers and consumer advocates in Alabama, California, Connecticut, Illinois, Missouri and Virginia – a cross-section of states in terms of geography, Medicaid expansion status, and implementation of a Medicaid family planning program. State interviews were supplemented by interviews with national experts, policymakers and family planning provider organizations. This study was conducted in Summer 2016 before the Presidential election.

  • Improving the Affordability of Coverage through the Basic Health Program in Minnesota and New York

    Issue Brief

    To date, Minnesota and New York are the only states to have adopted a Basic Health Program (BHP), an option in the Affordable Care Act (ACA) that permits state-administered coverage in lieu of marketplace coverage for those with incomes below 200% of the federal poverty level (FPL) who would otherwise qualify for marketplace subsidies. BHP covers adults with incomes between 138-200% of FPL and lawfully present non-citizens with incomes below 138% FPL whose immigration status makes them ineligible for Medicaid. This brief reviews Minnesota’s and New York’s approaches to BHP and assesses BHP’s impact on consumers, marketplaces, and state costs. Although there is uncertainty around the future of the ACA (including BHP) following the 2016 election, BHP implementation offers important lessons for consideration in future reforms about structuring coverage programs for low-income uninsured consumers.

  • Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA

    Issue Brief

    This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance because of a pre-existing condition if the Affordable Care Act (also known as Obamacare) were repealed or amended and such practices resumed.

  • Obamacare Debate: Where GOP Governors Stand on Repeal and Replace

    From Drew Altman

    As congress prepares to vote on repeal of the Affordable Care Act, Drew Altman discusses whether Republican governors and congressional Republicans will be at odds over key issues when it comes to repealing and replacing the law in this Wall Street Journal Think Tank column.