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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.”

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.
DATA

Marketplace Enrollment is Down in 2026—But All of the Data Isn’t in Yet

ANALYSIS

Higher Premium Payments or Higher Deductibles: The ACA's Tradeoffs

QUIZ

Test Your Knowledge of the Affordable Care Act

ANALYSIS

Competition Increased in Individual Market But Fell in Fully Insured Group Markets

Timely insights and analysis from KFF staff

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  • Pulling it Together: Forget Math and Science, Teach Civics (Or Why We Need to Bring Back Schoolhouse Rock)

    Perspective

    I am seldom surprised by our poll findings, but this month’s tracking poll produced a doozy.  Twenty-two percent of the American people think the Affordable Care Act has been repealed, and another 26 percent aren't sure.  Those are surprisingly large numbers even with the 52 percent who still know it is the law of the land. How could a repeal "vote" in the House -- however dramatic but still, only symbolic -- be misunderstood as…

  • 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…

  • Kaiser Health Tracking Poll — February 2011

    Feature

    In the wake of the health reform repeal vote in the U.S. House and the ongoing legal challenges over the individual mandate, nearly half the country either believes that the Patient Protection and Affordable Care Act (ACA) has been repealed and is no longer law (22 percent) or doesn’t know enough to say whether it is still law (26 percent). Roughly half of Americans (52 percent) accurately report that the ACA is still the law…

  • Medicaid Spending Growth and the Great Recession, 2007-2009

    Fact Sheet

    This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending. Fact Sheet (.pdf)

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

    Feature

    The Affordable Care Act (ACA) is coming up on a year old, but in the midst of continuing debate over the merits of the landmark health care overhaul, how well do Americans understand what the new law will actually do? As the 112th Congress prepared to take office and the discussion of repeal was on the rise, the Foundation included a ten-question "quiz" on the December Kaiser Health Tracking poll to try to answer this…

  • Research Brief: Insurance Coverage and Access to Care in Primary Care Shortage Areas

    Issue Brief

    As both federal and state governments gear up to implement the Patient Protection and Affordable Care Act (ACA), concerns about the supply and distribution of physicians, particularly primary care physicians, are being raised. In many areas of the country, there is a shortage of primary care physicians, and some worry about whether the current workforce can meet the growing demand for services that will likely accompany coverage expansions. To inform provider workforce issues related to…

  • Medicaid Spending Growth over the Last Decade and the Great Recession, 2000-2009

    Report

    This report examines Medicaid spending growth nationally during the last decade, with a focus on growth during the recession of 2007 to 2009. The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been…

  • State Budgets Under Federal Health Reform: The Extent and Causes of Variations in Estimated Impacts

    Issue Brief

    This analysis examines the potential costs and savings that the health reform law may generate for state budgets, a topic of great interest at a time when states continue to struggle with tight budgets in the wake of the recession. The analysis seeks to explain why recent state estimates of the likely impact of health reform on their budgets vary widely, and discusses the major expected sources of costs and savings as the new law…

  • Resources Examine Recession-Driven Record Medicaid Enrollment and Assess Medicaid Spending Growth

    Fact Sheet

    Three papers from the Foundation's Commission on Medicaid and the Uninsured examine Medicaid enrollment and spending during the recent recession. The analyses show Medicaid enrollment rose above 50 million people nationally for the first time in 2010, reflecting the program’s counter-cyclical role of helping people who become uninsured when the economy falters, with many turning to Medicaid after losing jobs and employer-based health insurance. Without access to Medicaid coverage, millions more people who suffered economic…

  • Reaching for the Stars: Quality Ratings of Medicare Advantage Plans, 2011

    Issue Brief

    New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012 In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014. This policy brief by the Kaiser Family Foundation examines the quality ratings of private…