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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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  • The Rubber is About to Hit the Road on Medicaid Cuts

    Quick Take

    Once Republicans in Congress get specific about Medicaid cuts, it will become more tangible and clearer who will be affected. Changes to the status quo in health care rarely get more popular when the details get filled in.

  • Most of the Public Oppose Major Federal Cuts to Health Agencies and Programs and Say They Have Been Made “Recklessly”

    News Release

    As the Trump administration and Congress pursue broad cuts to federal health agencies and budgets, most of the public, including some Republicans, oppose deep budget and staffing cuts to federal health programs and agencies, a new KFF Health Tracking Poll finds. Across a range of questions, large majorities of Democrats and independents oppose the Trump administration’s major cuts to federal health agencies and programs, while Republicans are more supportive. Those who identify with President Trump’s…

  • Responding to Federal Medicaid Reductions: Which States Are Most at Risk?

    Issue Brief

    A new KFF analysis examines a range of measures that may make it harder for states to respond to possible federal Medicaid cuts and finds that six states (Kentucky, Mississippi, Missouri, New Mexico, South Carolina, and West Virginia) rank in the top five for multiple risk categories. Across four broad categories of measures that could affect demand for Medicaid and states’ abilities to raise revenue or reduce spending—population demographic characteristics, health status of Medicaid enrollees,…

  • Poll: New Tax and Budget Law Remains Largely Unpopular; Nearly Half Say It Will Hurt Their Families, though Republicans and MAGA Supporters Are More Optimistic

    News Release

    Nearly half (46%) of the public says that they expect the new tax and budget law signed by President Trump earlier this month to generally hurt them and their families, nearly twice the share (26%) who say it will generally help, a new KFF Health Tracking Poll finds. Among people who rely on Medicaid for their health coverage, two-thirds (65%) say it will hurt their families compared to one in five (18%) who say it…

  • How Much and Why ACA Marketplace Premiums Are Going Up in 2026

    Issue Brief

    This analysis of initial rate filings from all 50 states and DC shows ACA Marketplace insurers are proposing a median premium increase of 18% for 2026, more than double last year’s 7% median proposed increase. The analysis includes proposed rate changes by state and insurer.

  • I am covered by Medicaid, but I’m wondering if I can drop my Medicaid and purchase one of the health plans offered through the Marketplace instead?

    FAQs

    While you are allowed to purchase Marketplace coverage, if you are currently covered by Medicaid or have been told you are eligible for Medicaid, you are not eligible for premium tax credits that make Marketplace coverage more affordable for people with lower incomes. Without the Marketplace tax credits, the cost of a Marketplace plan will likely be unaffordable. Medicaid offers comprehensive coverage with no or low premiums and limited out-of-pocket costs.

  • What did Sen. JD Vance mean by ‘Reinsurance?’

    Quick Take

    Vance’s debate comment likely refers to state reinsurance waivers, largely approved by the Trump Administration. These waivers aimed to lower unsubsidized premiums by offsetting insurer costs for very sick enrollees.

  • ¿Tengo que renovar la cobertura de Medicaid cada año?

    FAQs

    Si. Los estados generalmente comienzan el proceso enviando un aviso a cada individuo. Tenga en cuenta que el proceso de renovación puede verse diferente dependiendo de dónde viva, por lo que debe consultar el sitio web de Medicaid de su estado para ver qué requiere su proceso de renovación. Haga clic aquí para obtener una lista de sitios web y números de teléfono de cada agencia estatal de Medicaid para conocer el proceso y los…