Affordable Care Act

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.”

Timely insights and analysis from KFF staff

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  • Data Note: California’s Young Uninsured – A Look at 19- to 34-Year Olds Pre-ACA Rollout

    Poll Finding

    A Data Note based on the Kaiser Family Foundation California Uninsured Baseline Survey In California, as across the United States, the young uninsured are a key piece of the new Affordable Care Act (ACA) marketplace puzzle. Having a good-sized component of young people, with their generally more robust health and less frequent need for medical care and prescription drugs, in the newly created insurance pools would provide an important counterbalance to the incoming group of…

  • 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.

  • State Marketplace Profiles: New Hampshire

    Other Post

    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 Exchange Profiles: Ohio

    Other Post

    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: New York

    Other Post

    Final update made on September 30, 2013 (no further updates will be made) Establishing the Marketplace After the New York State legislature failed to pass exchange legislation, Governor Andrew Cuomo (D) signed Executive Order 42 on April 12, 2012, to establish the New York Health Benefit Exchange.1  In August 2013, the state announced that the online marketplace would be called NY State of Health.2  Structure: The Executive Order establishes the New York Health Benefit Exchange…

  • State Exchange Profiles: Louisiana

    Other Post

    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 Marketplace Profiles: Colorado

    Other Post

    Final update made on November 8, 2013 (no further updates will be made)  Establishing the Marketplace On June 1, 2011, Governor John Hickenlooper (D) signed SB 11-200 into law, establishing the Colorado Health Benefit Exchange.1  In January 2013, the Exchange announced that the online Marketplace would be called Connect for Health Colorado (C4HCO). Structure: The legislation defines Colorado’s Marketplace as a quasi-governmental organization, specifically a "nonprofit unincorporated public entity." Governance: The Marketplace is governed by a 12-member board.…

  • State Exchange Profiles: Alaska

    Other Post

    Final update made on December 4, 2012 (no further updates will be made)  Establishing the Exchange On July 17, 2012, Governor Sean Parnell (R) announced that Alaska will not create a state-run 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 2011 legislative session and reconsidered in 2012, it failed to pass. Prior to the announcement that the…

  • State Exchange Profiles: Virginia

    Other Post

    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 Marketplace Profiles: Illinois

    Other Post

    Final update made on October 15, 2013 (no further updates will be made) Establishing the Marketplace While Governor Pat Quinn (D) had considered establishing a state-based marketplace via executive order, he began moving in the direction of a state-federal partnership marketplace in July 2012.1 ,2  While the state has established a Partnership Marketplace, the administration still intends to transition to a fully State-based Marketplace in 2015 and will continue with the necessary planning. Illinois will be…