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.
Affordable Care Act
The ACA Marketplace
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.”
new and noteworthy
POLLING
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.
Timely insights and analysis from KFF staff
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Which Congressional Districts Could See the Greatest ACA Premium Payment Increases?
If the enhanced premium tax credits expire this year, the impact on ACA enrollees’ premium payments will vary by income, age, and geography. Among the five congressional districts with the highest premium increases, premiums will increase by over 500%. ... more
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A Steep Subsidy Cliff Looms for Older Middle-Income Enrollees if ACA Enhanced Tax Credits Expire
The expiration of the ACA enhanced premium tax credits at the end of this year would reintroduce the “subsidy cliff,” which abruptly ends the credit for Marketplace enrollees earning over 400% of poverty. That means some middle-income enrollees, especially older ones, would spend a much larger share of their income on premium payments than those… ... more
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Is it Too Late for ACA Insurers to Change Their Premiums?
Affordable Care Act Marketplace insurers are raising premiums by an average of 18% next year, due in part to the expiring enhanced premium tax credits. Even if the credits are extended in shutdown negotiations, it is unlikely that insurers will have time to revise premiums, though the credits would still offer enrollees relief from them. ... more
Lynne Cotter 
Shameek Rakshit 
Cynthia Cox Subscribe to KFF Emails
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