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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.

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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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  • Pre-X Redux

    From Drew Altman

    With the focus now mainly on exchanges, Medicaid expansions, and enrolling the uninsured in newly available coverage arrangements, there is less attention lately to the ACA insurance reforms which have always been the most popular parts of the law – changes which could affect every American’s insurance in some way and which go into effect regardless of the implementation decisions states make.  In this column, I draw on our recent tracking polls to review where…

  • Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California

    Issue Brief

    This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.

  • California’s Health Care Environment and Health Reform Efforts: June 2013 Update

    Issue Brief

    This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state's "Bridge to Reform" Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.

  • Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

    Issue Brief

    This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

  • An Employer Health Benefits Balance Sheet

    Perspective

    There seems to be growing interest in the question of how many employers will keep offering coverage to their full-time employees once the Affordable Care Act (ACA) is fully implemented in 2014, or instead will choose to stop offering coverage and pay a penalty. While there is some good analysis and plenty of conjecture, it is impossible to predict with any certainty how employers will react at this moment because some of the key rules…

  • CBO’s Estimate of Repealing Exchange Grants: The Importance of Being Effective

    Perspective

    The Congressional Budget Office (CBO) recently released an analysis of a bill that would repeal grants to states under the health reform law to help them establish health insurance purchasing exchanges. Not surprisingly, CBO finds that the bill would reduce federal spending due to the fact that expected grants won't be provided, to the tune of $1.9 billion over ten years. But, that's not the biggest effect on the federal budget. CBO also finds that…

  • Measuring the Affordability of Employer Health Coverage

    Perspective

    A recent draft regulation issued by the Treasury Department describes who is eligible for premium tax credits to help them afford coverage offered through health insurance exchanges beginning in 2014. Tax credits will be available to people with incomes between 100 and 400 percent of the poverty level who are not eligible for public coverage such as Medicaid or Medicare and who are not offered affordable health coverage by an employer. The approach that the…

  • The Budget Trigger and Health Reform

    Perspective

    No doubt it will take some time to sort out how elements of the debt deal (formally "The Budget Control Act of 2011") will all work. Delving into the details of how it affects subsidies in the Affordable Care Act (ACA) to make insurance more affordable helps to illustrate how complex this business can be. Let's start with a short primer on the ACA subsidies. Starting in 2014 people buying insurance on their own in…

  • Pop Quiz: Assessing Americans’ Familiarity with the Health Care Law

    Perspective

    Based on the December Kaiser Health Tracking Poll, the latest KFF data note explores Americans’ awareness of what the Affordable Care Act (ACA) will do. As the 112th Congress prepared to take office and the discussion of repeal was on the rise, we 'quizzed' Americans on whether they thought a series of ten provisions were included in the new law, ranging from five items that are part of the law (i.e., Medicaid expansion, changes in…

  • Remember the People Outside of the Exchanges

    Perspective

    There has been a substantial amount of focus on the recently released draft regulations governing state-based health insurance exchanges under the Affordable Care Act (ACA). And that's appropriate, since the exchanges have the important roles under reform of providing consumers with easier access to insurance and facilitating tax credits and cost-sharing subsidies that make coverage more affordable. But, as central as exchanges will likely be, it's important to remember that there are other key provisions that help…