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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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  • A Guide to the Supreme Court’s Review of the Contraceptive Coverage Requirement

    Issue Brief

    This issue brief dissects the issues raised by the legal challenges to the Affordable Care Act’s requirement that private insurance plans include contraception as part of their coverage of preventive services for women. Over 40 for-profit corporations and over 40 nonprofit corporations have filed lawsuits claiming that the requirement to provide their employees with contraceptives violates their religious rights. On November 26, 2013, the Supreme Court agreed to hear two cases filed by for-profit corporations, Hobby Lobby and Conestoga Wood Specialties, that claim that this requirement violates their religious rights. At the crux of these cases is a question that the Supreme Court has not previously addressed: Do for-profit corporations have religious protections under the 1993 Religious Freedom Restoration Act and the First Amendment? The brief provides background on how the ACA’s contraceptive requirement works, summarizes some of the legal challenges brought by for-profit and non-profit organizations and discusses the implications of potential rulings by the Supreme Court.

  • A Profile of Community Health Center Patients: Implications for Policy

    Issue Brief

    Community health centers are a key source of primary care in underserved areas. Their role will grow as coverage expands under the ACA. To sharpen understanding of the health center patient population, this brief compares them to the low-income population overall, using the Health Center Patient Survey and National Health Interview Survey. The pre-ACA profile of health center patients that emerges sets the stage for measuring change and highlights important implications of states’ Medicaid expansion decisions.

  • Data Note: Attempting to Measure Early Impact of the ACA through National Public Opinion Polls- A Note of Caution and What to Watch For

    Feature

    After the October start of open enrollment, under the Affordable Care Act, many journalists, policymakers, and the public at large are eager for early data indicating how the law is working from the perspective of potential enrollees. In particular, given the problems with Healthcare.Gov and some of the state exchange websites, many people want quantitative data about people’s experiences attempting to purchase or enroll in some sort of health insurance coverage using these mechanisms.
    This Data Note raises a note of caution about the possible pitfalls of using standard national public opinion polls to make judgments about Americans’ early experiences with health plan enrollment under the ACA.

  • Kaiser Health Tracking Poll: November 2013

    Feature

    Amid heavy news coverage of problems with the Affordable Care Act's rollout, the November Kaiser Health Tracking Poll finds a significant negative shift in the public's views of the law, with roughly half now holding an unfavorable view and just a third holding a positive one.

  • Fast Track to Coverage: Facilitating Enrollment of Eligible People into the Medicaid Expansion

    Issue Brief

    To help states launch the Affordable Care Act (ACA) Medicaid expansion and efficiently enroll eligible individuals, CMS has offered states a series of facilitated enrollment options. These options include strategies, referred to as “fast track enrollment” in this issue brief, that allow states to enroll eligible individuals into coverage using data already available from their Supplemental Nutrition Assistance programs (SNAP) and/or their Medicaid or Children’s Health Insurance Program (CHIP) programs for children. This issue brief provides an overview of the new “fast track” enrollment options, including how they have been implemented, their impacts, and key lessons learned. It is based on a series of interviews with state officials in Arkansas, Illinois, Oregon and West Virginia conducted by Manatt Health Solutions and the Kaiser Commission on Medicaid and the Uninsured in October 2013.

  • Healthy Indiana Plan and the Affordable Care Act

    Fact Sheet

    This fact sheet provides an overview of the Healthy Indiana Plan, Indiana's 1115 waiver demonstration project, and how it relates to the Affordable Care Act's Medicaid expansion.