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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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  • State Marketplace Profiles: New Hampshire

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    Final update made on November 1, 2013 (no further updates will be made) Establishing the Marketplace On June 18, 2012, Governor John Lynch (D) signed HB 1297 into law, which prohibits the state from participating in or enabling a state-based health insurance Marketplace. However, HB 1297 allows for state agencies or departments to “operate specific functions of a federally-facilitated exchange."1  Given this authority, newly-elected Governor Maggie Hassan (D) informed federal officials on February 13, 2013 that…

  • State Marketplace Profiles: Michigan

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    Final update made on November 26, 2013 (no further updates will be made) Establishing the Marketplace While Governor Rick Snyder (R) supports the creation of a State-based Marketplace, he acknowledged on November 16, 2012, that without authorizing legislation, he would plan for a State-federal Partnership Marketplace.1  The state began moving in the direction of a partnership in August 2012 due to legislative opposition that left the state unable to meet the federal timetable for implementation.2  Michigan will…

  • State Exchange Profiles: Ohio

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    Final update made on March 25, 2013 (no further updates will be made) Establishing the Exchange On November 16, 2012, Governor John Kasich (R) notified federal officials that Ohio would default to a federally-facilitated exchange; however, the state would maintain regulatory control over its insurance industry.1 The Governor also indicated Ohio would maintain control over Medicaid eligibility determinations. Prior to the announcement, the Department of Insurance in collaboration with other stakeholder agencies solicited subcontractors’ assistance for…

  • State Marketplace Profiles: District of Columbia

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    Final update made on October 1, 2013 (no further updates will be made) Establishing the Marketplace On December 20, 2011 the District of Columbia City Council gave final approval to a bill establishing the District of Columbia Health Benefit Exchange Authority (HBX) and in late January 2012, Mayor Vincent Gray (D) signed the legislation into law (Act 19-269).1  The bill was also subject to a 30-day Congressional review. In June 2013, the District of Columbia announced that its new…

  • State Exchange Profiles: Louisiana

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    Final update made on December 13, 2012 (no further updates will be made) Establishing the Exchange Governor Bobby Jindal (R) announced that Louisiana will not pursue the establishment of a state-based health insurance exchange and instead will allow the federal government to operate an exchange in the state.1 While a bill establishing an exchange was introduced in the 2012 legislative session, it was not supported by the Governor and failed when the legislative session ended (SB…

  • State Exchange Profiles: Vermont

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    Final update made on July 24, 2013 (no further updates will be made) Establishing the Exchange On May 26, 2011, Governor Peter Shumlin (D) signed into law HB 202, a far-reaching health reform law that puts the state on a path toward establishing a single-payer health care system.1  As an interim step, the law created the Vermont Health Benefit Exchange to meet the requirements of federal health reform. The state plans to put into place…

  • State Exchange Profiles: Virginia

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    Final update made on July 12, 2013 (no further updates will be made) Establishing the Exchange On December 14, 2012, Governor Bob McDonnell (R) informed federal officials that Virginia would not continue to plan for a state-based health insurance exchange.1  Prior to the decision, Governor McDonnell had signed HB 2434 into law declaring the state’s intent to establish a state-based health insurance exchange.2  The legislation was based on a recommendation by the Virginia Health Reform Initiative Advisory…

  • State Exchange Profiles: South Dakota

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    Final update made on April 19, 2013 (no further updates will be made)  Establishing the Exchange On September 26, 2012, Governor Dennis Daugaard (R) announced that South Dakota would not establish an exchange.1However, the state intends to maintain regulatory authority over the health insurance market and perform the plan management function for the exchange.2 The decision to have a federally-facilitated exchange was made after an inter-agency work group and a taskforce of stakeholders and legislators explored…

  • State Exchange Profiles: Indiana

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    Final update made on December 13, 2012 (no further updates will be made)  Establishing the Exchange In November 2012, Governor-elect Mike Pence (R) announced that he would not move forward with setting up a state-based health insurance exchange when he takes office in 2013.1 During his term, Governor Mitch Daniels (R) had signed Executive Order #11-01 in 2011 to conditionally establish and operate the Indiana Insurance Market, Inc., a nonprofit corporation to serve as the…

  • State Exchange Profiles: Arizona

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    Final update made on December 4, 2012 (no further updates will be made) Establishing the Exchange  On November 28, 2012, Governor Jan Brewer (R) informed federal officials that Arizona would default to a federally-facilitated health insurance exchange.1 Prior to her decision to default, the Governor had established the Office of Health Insurance Exchange to “organize the health insurance marketplace for easier evaluation by individuals and small businesses to acquire affordable health insurance.”2 While legislation establishing a…