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Affordable Care Act Signups Are Down, But Still an Incomplete Picture

Data from CMS may not fully show how much the expiration of the enhanced premium tax credits has affected enrollment in the ACA Marketplaces. The extent of enrollment changes likely won’t be known until this summer, when effectuated enrollment data are typically released.
DATA

Marketplace Enrollment Snapshot for Open Enrollment 2026

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

Enhanced Premium tax credits

2025 KFF Marketplace Enrollees Survey

If their premium payments double, about one in three ACA enrollees say they would be “very likely” to look for a lower-premium Marketplace plan.

Updated Larry QT on ePTCs

There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks

A discharge petition in the House paves the way for a vote on a three-year extension of the tax credits, which would provide ACA enrollees premium relief whenever it comes. While there is still time to extend the enhanced tax credits, with each passing day, more and more ACA Marketplace enrollees are going to drop their health insurance when faced with eye-popping increases in their premium payments, writes KFF’s Larry Levitt.

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  • 2025 KFF Marketplace Enrollees Survey

    Poll Finding

    This survey explores how ACA Marketplace enrollees expect to respond if their premium payments doubled as expected in 2026 when enhanced premium tax credits are set to expire. About a third would very likely look for a lower-cost plan, even if it had higher deductibles, and about a quarter would very likely end up uninsured. The survey also examines how increased health care costs may affect their finances and the potential impact in next year's elections.

  • Mapping the Uneven Burden of Rising ACA Marketplace Premium Payments due to Enhanced Tax Credit Expiration

    Issue Brief

    Enhanced premium tax credits expire at the end of this year. Among those with incomes over 400% poverty who are losing the tax credit altogether, the impact will be greatest for those whose unsubsidized premiums are highest: older Marketplace enrollees and those living in higher-premium locales. The maps in this brief show how much average premium payments would increase for 2026 benchmark silver plans with the expiration of enhanced premium tax credits at three income levels above an income cap of 400% of federal poverty for a 40-year-old and 60-year-old individual, namely 401%, 501% and 601%.

  • The New ACA Repeal and Replace: Health Savings Accounts

    Policy Watch

    Proposals from some Republicans in Congress would effectively repeal some or all of the ACA premium tax credits and replace them with contributions to Health Savings Accounts (HSAs) or something similar. Senator Rick Scott proposes “Trump Health Freedom Accounts” and Senator Bill Cassidy proposes HSA contributions available only for people who enroll in bronze level ACA plans to pay for out-of-pocket health care costs.

  • Deductibles in ACA Marketplace Plans, 2014-2026

    Fact Sheet

    This analysis documents average deductibles for Affordable Care Act Marketplace plans available on Healthcare.gov in 2026 for all metal tiers, including silver plans after cost-sharing reductions are applied, as well as trend data since 2014.

  • KFF Health Tracking Poll: Public Weighs in on Health Care Debate and Government Shutdown 

    Poll Finding

    This poll finds that public support remains high for extending the enhanced ACA tax credits set to expire at the end of the year. Three quarters of the public favor of extending them, though support among Republicans has dipped since September. Most Democrats want a Congressional budget deal to include an extension of the tax credits.

  • How ACA Marketplace Costs Compare to Employer-Sponsored Health Insurance

    Issue Brief

    This analysis compares ACA Marketplace costs to employer-sponsored health insurance costs and finds that individual market premiums have become more similar to employer-sponsored premiums over time. In 2024, individual market insurance premiums averaged $540 per member per month, slightly below the average $587 per member per month premium for fully-insured employer coverage.