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The Enhanced Premium Tax Credits

About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

About Half of Adults with ACA Marketplace Coverage are Small Business Employees or Self-Employed and Could Face Higher Premiums Soon

About half (48%) of adults with ACA Marketplace coverage are employed by small businesses or are self-employed and could face higher premiums soon. Because the vast majority of individual market coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.

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ACA Marketplace Plans Nationally Are Seeking a Median 18% Premium Increase for 2026

This analysis of insurers’ initial rate filings for Affordable Care Act Marketplace plans in all 50 states and DC finds the median proposed increase for 2026 is 18%, more than double last year’s proposed increase. The analysis also shows proposed rate changes by state and insurer.


Tariffs Are Driving up Premiums for Small Businesses

Estimates of Additional Uninsured People Across the States

ACA Provisions in the 2025 Federal Budget Reconciliation Law

Health Insurance Marketplace Calculator

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  • KFF Health Tracking Poll: Public Weighs Health Care Spending and Other Priorities for Incoming Administration

    Feature

    With the incoming Trump administration and Republican-led Congress looking to ways to reduce federal spending, this Poll finds that the Medicare and Medicaid programs remain broadly popular, and more people favor more spending on those programs than less spending. Among potential actions on health, the public sees price transparency and limiting chemicals in food as top priorities. Few say so about cuts to Medicaid and restrictions on abortion.

  • Claims Denials and Appeals in ACA Marketplace Plans in 2023

    Issue Brief

    This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for denials is limited, and few consumers appeal claims denials.

  • What’s Next for the Affordable Care Act?

    Event Date:
    Event

    Health coverage enrollment through the ACA marketplaces now exceeds 24 million people, a dramatic increase in recent years fueled largely by enhanced premium aid. With the subsidies set to expire at the end of this year, Congress and the Trump Administration will be faced with a choice of whether and how to extend the subsidies, alongside broader discussion about the budget. On February 10, KFF’s Larry Levitt moderated a 45-minute virtual discussion with an expert panel to explore these questions and more about the future of the ACA.

  • The Symbolic Manipulation of Health Issues in Elections

    From Drew Altman

    KFF President and CEO Drew Altman explains why data and facts, policy plans and lists of accomplishments do not connect with many voters. Understanding the symbolic dimensions of politics and issues is critical for experts. We can reach a share of the public with facts and data but need additional strategies to reach everyone, including storytelling and trusted messengers.

  • The CBO Report That Didn’t Roar

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman discusses a recent Congressional Budget Office (CBO) estimate that the Centers for Medicare and Medicaid Innovation (CMMI)'s payment and delivery demonstrations have cost Medicare money, and what it means for the future of value-based payment.

  • SCOTUS Case Could Weaken the Impact of Regulation on Key Patient and Consumer Protections

    Issue Brief

    This brief discusses the longstanding legal doctrine, Chevron deference, being challenged in two cases before the U.S. Supreme Court and includes examples of what could be at stake for health care consumers should federal courts no longer use this doctrine to address litigation related to federal health regulations. The focus here is on patient and consumer protection regulation, but overturning the Chevron deference would have implications in all areas of health care.

  • The Implications of the Public’s Pre-existing Condition Amnesia

    Perspective

    KFF’s Larry Levitt discusses waning awareness of the Affordable Care Act’s provisions protecting people with pre-existing conditions and examines the Republican Study Committee's budget proposal, which proposes to repeal the provisions.