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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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  • Medicaid Family Planning Programs: Case Studies of Six States After ACA Implementation

    Report

    In light of the coverage trends and other ACA-related changes, this paper describes the impact on women and their partners, as well as family planning providers, of the impact of family planning expansion programs under Medicaid. It is based largely on interviews with state officials, providers and consumer advocates in Alabama, California, Connecticut, Illinois, Missouri and Virginia – a cross-section of states in terms of geography, Medicaid expansion status, and implementation of a Medicaid family…

  • Why Trump’s Dealmaking Model Doesn’t Fit Health Care Policy

    From Drew Altman

    In this column as an Axios contributor, Drew Altman discusses President Trump's threat to withhold cost sharing subsidies and questions whether his approach to deal making can bridge health care's partisan and ideological divide. "Health policy is not like real estate," he says.

  • The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments

    Issue Brief

    This analysis estimates that total federal spending on Affordable Care Act marketplace subsidies would rise $2.3 billion, or 23 percent, in 2018 if payments for the cost-sharing reduction program were eliminated and insurers increased premiums to compensate. Established to reduce out-of-pocket costs for marketplace enrollees with lower incomes, the cost-sharing payments are being challenged in a lawsuit from the U.S. House.

  • Federal Government Could See Net Increase of $2.3 Billion in Costs in 2018 if ACA Cost-Sharing Reduction Payments Eliminated

    News Release

    Ceasing payments for the Affordable Care Act’s (ACA) cost-sharing reduction program could save $10 billion, but cost an additional $12.3 billion in premium tax credits – an estimated net increase of $2.3 billion, or 23 percent, in federal spending on marketplace subsidies – in 2018, if insurers continue to participate in ACA marketplaces, according to a new analysis from the Kaiser Family Foundation. The cost-sharing subsidies, established to reduce out-of-pocket costs for ACA marketplace enrollees…

  • Medicaid’s Role in West Virginia

    Fact Sheet

    This fact sheet provides data on Medicaid's role in West Virginia. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect West Virginia.

  • Medicaid’s Role in Alaska

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Alaska. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Alaska.

  • Medicaid’s Role in Louisiana

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Louisiana. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Louisiana.

  • Medicaid’s Role in Nevada

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Nevada. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Nevada.

  • Medicaid’s Role in Tennessee

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Tennessee and describes how implementing a per capita cap or block grant would affect Tennessee.