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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  • 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 Marketplace Profiles: Kentucky

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    Final update made on November 11, 2013 (no further updates will be made) Establishing the Marketplace On July 17, 2012, Governor Steven L. Beshear (D) issued Executive Order 587 establishing the Kentucky Health Benefit Exchange (KHBE) after the Supreme Court ruled to uphold the Affordable Care Act (ACA).1  In May 2013, the state announced that its online Marketplace would be called kynect. Prior to the Executive Order, the Kentucky Cabinet for Health and Family Services led Marketplace…

  • State Exchange Profiles: Wisconsin

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    Final update made on December 11, 2012 (no further updates will be made) Establishing the Exchange  On November 16, 2012, Governor Scott Walker (R) notified federal officials that Wisconsin would default to a federally-facilitated health insurance exchange.1 After initial efforts to develop a state-based health insurance exchange, Governor Walker announced in July 2012, he would not take any action to implement federal health reform until after the November elections.2 In 2011, Walker had issued an executive order…

  • State Marketplace Profiles: California

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    Final update made on November 26, 2013 (no further updates will be made) Establishing the Marketplace On September 30, 2010, former Governor Arnold Schwarzenegger (R) signed into law two complementary bills, AB 1602 and SB 900, to establish the California Health Benefit Exchange. California was the first state in the nation to pass legislation creating a health insurance Marketplace after the enactment of federal health reform.1   Current Governor Jerry Brown (D) called a special legislative…

  • State Marketplace Profiles: Maryland

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    Final update made on November 13, 2013 (no further updates will be made)  Establishing the Marketplace On April 12, 2011, Governor Martin O’Malley (D) signed SB 182/HB 166 into law establishing the Maryland Health Benefit Exchange (MBHE).1   In May of the following year, Governor O’Malley signed additional Marketplace legislation (SB 372/HB 433) which addressed multiple Marketplace implementation and operational issues and was based on recommendations by the Board of Directors and advisory groups from 2011.2 …

  • State Exchange Profiles: Pennsylvania

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    Final update made on December 12, 2012 (no further updates will be made) Establishing the Exchange On December 12, 2012, Governor Tom Corbett (R) notified federal officials that Pennsylvania would default to a federally-facilitated health insurance exchange.1 Prior to the announcement, the Pennsylvania Insurance Department had taken the lead with exchange planning. The Insurance Department, released an extensive report in November 2011 that suggested broad support for a state-run exchange.2 In January 2012, the Department released…

  • State Marketplace Profiles: Connecticut

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    Final update made on September 27, 2013 (no further updates will be made)  Establishing the Marketplace On July 1, 2011, Governor Dan Malloy (D) signed SB921 (Public Act 11-53) into law establishing the Connecticut Health Insurance Exchange.1   Legislation altering the composition of the Exchange Board passed in June 2012.2 3  In December 2012, the Exchange announced that its new name would be “Access Health CT.” Structure: The legislation defines Connecticut’s Health Insurance Exchange as a quasi-governmental organization, specifically "a…

  • How People Get Covered

    Feature

    How-People-Get-Covered-HEALTHREFORM Download Source Kaiser Family Foundation  

  • Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010

    Feature

    Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010 Download Source Kaiser Family Foundation analysis of 2010 insurer filings to the National Association of Insurance Commissioners and the California Department of Managed Health Care using the Mark Farrah Associates Health Coverage Portal TM. Market share was calculated as the percent of the state’s individual insurance market enrollment accounted for by each parent company (measured in member months)