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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.”

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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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  • Marketplace Sign-ups Increased by 21% in 2022

    Feature

    Forty-seven states saw Marketplace enrollment increase, ranging from 1% in Rhode Island to 42% in Texas. In 20 states, enrollment increased by more than 20%.

  • Network Adequacy Standards and Enforcement

    Issue Brief

    Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.

  • People With HIV in Non-Medicaid Expansion States: Who Could Gain Coverage Eligibility Through Build Back Better or Future Expansion?

    Issue Brief

    In this analysis, we explore the implications of the Build Back Better Act's current coverage provisions for people with HIV in select non-expansion states. We estimate the size of the population that could gain eligibility as well as their socio-demographic characteristics, examine their affordability barriers and assess the potential impact on the Ryan White HIV/AIDS Program. We also explore what Medicaid expansion could mean in these non-expansion states for people with HIV.

  • 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 help, and what difference it makes as well as who does not get help and why.

  • 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.

  • 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.

  • JAMA Forum: Trump vs Biden on Health Care

    Perspective

    In this September 2020 post for The JAMA Health Forum, Larry Levitt highlights differences in the records and policy plans of President Donald Trump and former Vice President Joe Biden on key health care issues.