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.”

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  • How Unaffordable is Health Care?

    Perspective

    In his latest JAMA Forum column, KFF’s Larry Levitt explores how unaffordable health care is in the U.S. in the context of the debate over extending enhanced Affordable Care Act premium tax credits and an upcoming election where affordability will likely be front and center.

  • State-Based Efforts Will Provide Limited Relief from Enhanced Tax Credit Expiration

    Policy Watch

    After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating State-Based Marketplaces (SBMs), have been preparing for this possibility for months and are moving to blunt the impact on consumers by implementing their own state-funded subsidies and implementing other programs aimed at stabilizing the cost of unsubsidized premiums.

  • KFF Health Tracking Poll: Health Care Costs, Expiring ACA Tax Credits, and the 2026 Midterms

    Poll Finding

    Looking ahead to the midterm elections, health care costs are the public’s top economic concern, and many voters say the issue will have a major impact on their vote. On health care issues, including the cost of health care, voters currently trust Democrats more than Republicans, though neither party has an advantage on addressing the overall cost of living. Following the expiration of the ACA enhanced tax credits, two-thirds of the public say Congress did…

  • Tracking the Public’s Views on the ACA

    Tracker

    This interactive tool tracks public opinion on the Affordable Care Act, from the inception of the law to the present. It highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

  • Over-the-Counter Oral Contraceptive Pills

    Issue Brief

    Oral contraceptives are the most commonly used method of reversible contraception in the U.S. In July 2023, the FDA approved Opill, the first daily oral contraceptive pill to become available over the counter (OTC) without a doctor’s prescription. This issue brief provides an overview of OTC oral contraceptives and laws and policies related to insurance coverage.

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy…

  • I will lose my employer coverage mid-month. Can my Marketplace coverage start the same month when my old coverage is terminated?

    FAQs

    Yes, your Marketplace coverage will begin the first day of the month after you select your QHP during the special enrollment period triggered by your loss of other job-based coverage. If you sign up for a Marketplace plan during a special enrollment period, your coverage will take effect on the first day of the month after you select your plan, even if you made your selection after the 15th of the month. So, for example,…