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.
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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.
Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age.
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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Premium tax credits are available to people who buy Marketplace coverage and whose income is at least as high as the federal poverty level. For an individual, that means an income of at least $15,650 in 2026. For a family of four, that means an income of at least $32,150 in 2026.
In nearly all states, pregnancy-related Medicaid provides the same (or similar) benefits as Medicaid for other adults and so is considered minimum essential coverage (MEC). In general, people who are eligible for other MEC are not eligible for advance premium tax credits (APTC).
Sí. Al presentar su declaración de impuestos, deberá calcular el subsidio al que realmente tuvo derecho ese año. La determinación del mercado que recibió el año pasado se basó en su estimación de buena fe de sus ingresos anuales. Al presentar su declaración de impuestos, necesitará dos formularios especiales: el 1095-A y el 8962.
La elegibilidad para comprar cobertura en el mercado se basa en el lugar donde establezca su residencia permanente. Algunas aseguradoras ofrecerán redes más grandes que otros planes y pueden ofrecer redes de proveedores regionales o nacionales.
Si. El beneficio de desempleo generalmente se incluye en sus ingresos brutos y se tiene en cuenta para determinar la elegibilidad para los créditos fiscales (subsidios). Recientemente, la Ley CARES previó un aumento temporal de emergencia en los beneficios de desempleo de $600 por semana, en respuesta a la pandemia de COVID-19.
En la mayoría de los estados, sí. Generalmente, una aseguradora puede cobrarle hasta un 50% más si ha consumido productos de tabaco cuatro o más veces por semana en promedio durante los últimos 6 meses. Esto se denomina recargo por tabaco.
When you turn 65, you should sign up for Medicare and notify your Marketplace plan that you now qualify for Medicare coverage.
If you are currently enrolled in a student health plan, you can still apply for Marketplace coverage during the annual Open Enrollment period.
Si es un trabajador a tiempo completo y trabaja para un gran empleador, su empleador enfrentará una multa si no proporciona cobertura. Algunos empleadores pueden optar por pagar la multa y no ofrecer cobertura. Consulte con su empleador para ver lo que ofrecen.
Si. Muchas aseguradoras que ofrecen planes a través del mercado también ofrecen planes idénticos por fuera. Sin embargo, por fuera del mercado no hay subsidios disponibles para ayudar a pagar las primas mensuales ni para solventar los costos compartidos.
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