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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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  • Consumer Assistance in Health Insurance: Evidence of Impact and Unmet Need

    Issue Brief

    The Affordable Care Act (ACA) established in-person consumer assistance programs to help people identify coverage options and enroll. A variety of professionals provide consumer assistance, including Navigator programs that are funded through state and federal marketplaces, brokers who receive commissions from insurers, local non-profit organizations, and health care providers. In the spring of 2020, KFF surveyed consumers most likely to use or benefit from consumer assistance to learn who uses consumer assistance, why they seek…

  • New Survey Finds 1 in 5 Potential Marketplace and Medicaid Enrollees Used Consumer Assistance, But Many Others Report Trying and Failing to Obtain Help

    News Release

    A new KFF survey finds that nearly one in five potential marketplace and Medicaid enrollees – an estimated 7 million people - say that they got assistance applying for Affordable Care Act (ACA) marketplace plans or Medicaid in the past year, while one in eight – an estimated 5 million – tried and failed to obtain help. The survey suggests a shortage of consumer assistance prior to the COVID-19 pandemic, which has disrupted job-based health…

  • The Implications of COVID-19 for Mental Health and Substance Use

    Issue Brief

    This brief explores mental health and substance use during, and prior to, the COVID-19 pandemic. We highlight populations that were more likely to experience worse mental health and substance use outcomes during the pandemic and discuss some innovations in the delivery of services.

  • Contraception X Article: Out-of-Pocket Spending for Oral Contraceptives Among Women with Private Insurance Coverage After the Affordable Care Act

    Issue Brief

    In an article for Contraception X, KFF's Brittni Frederiksen, Matthew Rae, and Alina Salganicoff examine large employer plans to identify which types and brands of oral contraceptive pills have the largest shares of oral contraceptive users with out-of-pocket spending and which oral contraceptives have the highest average annual out-of-pocket costs after the ACA covered contraception under it's preventive services provisions.

  • Health Care and the 2020 Presidential Election

    Feature

    This side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a wide range of key health issues, including the response to the pandemic, the Affordable Care Act marketplace, Medicaid, Medicare, drug prices, reproductive health, mental health and opioids, immigration and health coverage, and health care costs.

  • Amid the Coronavirus Crisis, President Trump and Democratic Nominee Joe Biden Offer Widely Different Views on Health Care

    News Release

    President Trump and Democratic nominee Joe Biden hold widely divergent views on health issues, with the president’s record and response to the coronavirus pandemic likely to play a central role in November’s elections. A new KFF side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a wide range of key health issues, including the response to the pandemic, the Affordable Care Act marketplace, Medicaid, Medicare, drug prices, reproductive health, HIV, mental…

  • Webinar for Journalists: Results from Survey of People Who Bought Their Own Health Insurance Under the ACA

    Event Date:
    Event

    The Kaiser Family Foundation held a reporters-only webinar at 11 a.m. ET on Thursday, June 19 to release its new Survey of Non-Group Health Insurance Enrollees, providing a first look at people buying their own health insurance following the implementation of the Affordable Care Act. The first in a series, the new survey captures the previous insurance status of marketplace enrollees and the self-reported health status of enrollees in ACA-compliant coverage purchased on or off…

  • Survey of Non-Group Health Insurance Enrollees

    Report

    Executive Summary January 1, 2014 marked the beginning of several provisions of the Affordable Care Act (ACA) making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces (also known as “Exchanges”) and the availability of premium and cost-sharing subsidies for individuals with low to moderate incomes. Data from the Department of Health and…

  • Advancing Opportunities, Assessing Challenges: Key Themes from a Roundtable Discussion of Health Care and Health Equity in the South

    Issue Brief

    This brief summarizes the primary themes expressed by participants of a roundtable discussion of current and future opportunities and challenges for advancing health care and health equity in the South organized by Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Georgia.

  • Does the Affordable Care Act Cover the Uninsured?

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, discusses what a new Foundation survey finds about one of the biggest questions about the Affordable Care Act: whether it covers the uninsured.